Advertisement

 

 

Initiation of Antiretroviral Therapy during Acute HIV-1 Infection leads to A High Rate of Non-Reactive HIV Serology.

Author Information (click to view)

de Souza MS, Pinyakorn S, Akapirat S, Pattanachaiwit S, Fletcher JL, Chomchey N, Kroon ED, Ubolyam S, Michael NL, Robb ML, Phanuphak P, Kim JH, Phanuphak N, Ananworanich J, ,


de Souza MS, Pinyakorn S, Akapirat S, Pattanachaiwit S, Fletcher JL, Chomchey N, Kroon ED, Ubolyam S, Michael NL, Robb ML, Phanuphak P, Kim JH, Phanuphak N, Ananworanich J, , (click to view)

de Souza MS, Pinyakorn S, Akapirat S, Pattanachaiwit S, Fletcher JL, Chomchey N, Kroon ED, Ubolyam S, Michael NL, Robb ML, Phanuphak P, Kim JH, Phanuphak N, Ananworanich J, ,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2016 6 17() pii

Abstract
BACKGROUND
 Third- and fourth-generation immunoassays 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 non-reactive HIV-specific IgG, enrolled in an AHI study were offered immediate initiation of ART. Participants were tested at initiation, 12 and 24 weeks following treatment using standard second-, third- and fourth-generation immunoassays and Western blot.

RESULTS
 Participants (N=234) initiating ART at a median of 19 days (range 1-62) from HIV exposure demonstrated different frequencies of reactivity prior to and following 24 weeks of ART depending on the immunoassay. Third-generation immunoassay non-reactivity prior to ART was 48%, which decreased to 4% following ART (p<0.001). Fourth-generation immunoassay non-reactivity was 18% prior to ART and 17% following ART (p=0.720). Negative Western blot results were observed in 89% and 12% of participants prior to and following 24 weeks of ART, respectively (p <0.001). Seroreversion to non-reactivity during ART was observed to at least one of the tests in 20% of participants, with fourth-generation immunoassay 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. While fourth-generation immunoassay was the most sensitive at detecting AHI prior to ART, third-generation immunoassay was the most sensitive during treatment.

CLINICAL TRIALS REGISTRATION
 NCT00796146 and NCT00796263.

Submit a Comment

Your email address will not be published. Required fields are marked *

three × two =

[ HIDE/SHOW ]