Details

Autor(en) / Beteiligte

• de Souza, Mark S.
• Pinyakorn, Suteeraporn
• Akapirat, Siriwat
• Pattanachaiwit, Supanit
• Fletcher, James L. K.
• Chomchey, Nitiya
• Kroon, Eugene D.
• Ubolyam, Sasiwimol
• Michael, Nelson L.
• Robb, Merlin L.
• Phanuphak, Praphan
• Kim, Jerome H.
• Phanuphak, Nittaya
• Ananworanich, Jintanat

Titel

Initiation of Antiretroviral Therapy During Acute HIV-1 Infection Leads to a High Rate of Nonreactive HIV Serology

Ist Teil von

• Clinical infectious diseases, 2016-08, Vol.63 (4), p.555-561

Ort / Verlag

United States: Oxford University Press

Erscheinungsjahr

2016

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Background. Third- and fourth-generation immunoassays (IAs) are widely used in the diagnosis of human immunodeficiency virus (HIV) infection. Antiretroviral therapy (ART) during acute HIV infection (AHI) may impact HIV-specific antibodies, with failure to develop antibody or seroreversion. We report on the ability of diagnostic tests to detect HIV-specific antibodies in Thai participants initiating ART during AHI. Methods. Participants with detectable plasma HIV RNA but nonreactive HIV-specific immunoglobulin G, enrolled in an AHI study, were offered immediate initiation of ART. Participants were tested at initiation and at 12 and 24 weeks following treatment using standard second-, third-, and fourth-generation IAs and Western blot (WB). Results. Participants (N = 234) initiating ART at a median of 19 days (range, 1–62 days) from HIV exposure demonstrated different frequencies of reactivity prior to and following 24 weeks of ART depending on the IA. Third-generation IA nonreactivity prior to ART was 48%, which decreased to 4% following ART (P < .001). Fourth-generation IA nonreactivity was 18% prior to ART and 17% following ART (P = .720). Negative WB results were observed in 89% and 12% of participants prior to and following 24 weeks of ART, respectively (P < .001). Seroreversion to nonreactivity during ART was observed to at least one of the tests in 20% of participants, with fourth-generation IA demonstrating the highest frequency (11%) of seroreversion. Conclusions. HIV-specific antibodies may fail to develop and, when detected, may decline when ART is initiated during AHI. Although fourth-generation IA was the most sensitive at detecting AHI prior to ART, third-generation IA was the most sensitive during treatment. Clinical Trials Registration. NCT00796146 and NCT00796263.