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Link to original content: http://pubmed.ncbi.nlm.nih.gov/31917751/
Pattern and Frequency of Seroreactivity to Routinely Used Serologic Tests in Early-Treated Infants With HIV - PubMed Skip to main page content
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. 2020 Mar 1;83(3):260-266.
doi: 10.1097/QAI.0000000000002254.

Pattern and Frequency of Seroreactivity to Routinely Used Serologic Tests in Early-Treated Infants With HIV

Thanyawee Puthanakit  1   2 , Jintanat Ananworanich  3   4   5 , Siriwat Akapirat  6 , Supanit Pattanachaiwit  7 , Sasiwimol Ubolyam  2 , Vatcharain Assawadarachai  6 , Panadda Sawangsinth  5 , Thidarat Jupimai  1 , Suvaporn Anugulruengkitt  1 , Monta Tawan  1 , Pope Kosalaraksa  8 , Thitiporn Borkird  9 , Piyarat Suntarattiwong  10 , Suparat Kanjanavanit  11 , Mark S de Souza  5 ; RV475/HIV-NAT209 Study Group
Affiliations

Pattern and Frequency of Seroreactivity to Routinely Used Serologic Tests in Early-Treated Infants With HIV

Thanyawee Puthanakit et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Previous studies have shown low frequencies of seroreactivity to HIV diagnostic assays for infected infants treated with antiretroviral therapy (ART) early in infection.

Methods: Fifty-eight HIV-infected infants treated with ART at a median age of 1.9 months (range: 0.2-5.4) for up to 4 years of life were assessed for seroreactivity to 4 routinely used HIV clinical immunoassays (IA): Second-generation (2ndG) IA and 2 rapid diagnostic tests (RDT), based on third-generation principles, measuring antibody only and a fourth-generation (4thG) antigen/antibody IA. HIV Western blot assay was also performed to assess HIV-specific antibodies.

Results: The 2ndG IA demonstrated the highest frequency of seroreactivity in children (69%) followed by the 4thG IA (40%) and the RDT (26%) after one year of ART. Infants initiating ART during ages 3-6 months (N = 15) showed a greater frequency (range: 53%-93%) and breadth (median and range: 3 [1-4]) of reactivity across the assays compared with those treated within 3 months (N = 43):16%-61% and breadth (1 [0-4]). The 4thG IA showed significantly reduced reactivity relative to the 2ndG IA at one (P = 0.016) and 3 (P = 0.004) years of ART. Western blot profiles following 3 years of ART showed the highest frequency of reactivity to HIV Gag p24 (76%) and lowest reactivity to Env gp120 and gp41, with only 24% of children confirmed positive by the assay.

Conclusions: These results suggest that the use of 4thG IA and RDT test combination algorithms with limited HIV antigen breadth may not be adequate for diagnosis of HIV-infected children following early treatment.

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Figures

Figure 1:
Figure 1:
Frequency of HIV seroreactivity to four clinical immunoassays in 43 infants initiating ART within three months (A) and 15 infants (B) initiating ART between three to six months of age. Abbreviations: Architect, ARCHITECT HIV Ag/Ab Combo; Determine RDT, Abbott Determine HIV1/2 Rapid Diagnostic Test; Bioline RDT, Standard Diagnostics Bioline HIV-1/2 3.0 Rapid Diagnostic Test; Avioq, Avioq HIV-1 Microelisa System
Figure 2:
Figure 2:
Frequency of positive HIV antigens measured by Western blot assay for 25 infants at one and three years following ART initiation. *: p=0.045
See this image and copyright information in PMC

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