Diagnosis of primary HIV-1 infection and duration of follow-up after HIV exposure

Lindbäck, Stefan; Thorstensson, Rigmor; Karlsson, Annika C.; Sydow, M von; Flamholc, Leo; Blaxhult, Anders; Sönnerborg, Anders; Biberfeld, Gunnel; Gaines, Hans

doi:10.1097/00002030-200010200-00014

Cited by 121 publications

(91 citation statements)

References 16 publications

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“…Only 1 among the 53 patients included in the three-or four-drug treated cohorts where SPCR analysis was successful developed a M184I/V mutation during the initial phase of viral decay, despite advanced immunodeficiency in the chronically infected patients and an initial very high rate of viral replication in those with PHI [Lindback et al, 2000;Hoen et al, 2007]. The viral population present in the single patient with M184V during early therapy contained a 2.1 AE 0.3% mutant population after 6 weeks of treatment, but only wildtype virus in samples taken during the following 10 weeks.…”

Section: Discussionmentioning

confidence: 99%

Selection of drug‐resistant HIV‐1 during the early phase of viral decay is uncommon in treatment‐naïve patients initiated on a three‐ or four‐drug antiretroviral regimen including lamivudine

Bergroth¹,

Ekici²,

Gisslén³

et al. 2008

Journal of Medical Virology

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Therapy failure due to drug resistance development is a common phenomenon in HIV-infected patients. However, when the drug pressure leads to the earliest selection of drug-resistant HIV-1 populations is still unclear. In this study, the extent to which selection of the HIV-1 reverse transcriptase M184I/V mutations occur during the initial phase of viral decay in treatment-naïve HIV-1 infected patients receiving antiretroviral therapy (ART) was examined. Plasma virus from three cohorts of treatment-naïve patients initiating quadruple (n ¼ 43), triple (n ¼ 14) or dual (n ¼ 15) lamivudine-containing ART were analyzed for M184I/V during the first 6 months of therapy using direct sequencing and a sensitive selective real-time PCR method. Among quadruple ART patients, who all were treated at primary HIV-1 infection, only one patient developed M184V after 6 weeks of therapy, having had wild-type virus at baseline. No mutations were found in chronically infected patients on triple ART. In patients on dual therapy, M184I/V mutants were found frequently. Selection of M184I/V mutants was found to be rare during the initial phase of viral decay after initiation of ART in adherent patients given a three or fourdrug combination, in contrast to those receiving a less potent regimen. The results suggest that triple and quadruple lamivudine þ PI or PI/r containing ART given to treatment-naïve adherent patients is potent enough to prevent development of resistance during the first months of therapy.

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Section: Discussionmentioning

confidence: 99%

Selection of drug‐resistant HIV‐1 during the early phase of viral decay is uncommon in treatment‐naïve patients initiated on a three‐ or four‐drug antiretroviral regimen including lamivudine

Bergroth¹,

Ekici²,

Gisslén³

et al. 2008

Journal of Medical Virology

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“…In newly infected individuals HIV RNA level will increase rapidly and predictably in serial samples. [1] The peak level of RNA in the blood is usually in the millions and precedes the antibody seroconversion because of the rapid dissemination of virus which happens during that period. [2,3] .…”

Section: Discussionmentioning

confidence: 99%

“…The better markers for the detection of HIV infection at this stage are the plasma HIV RNA and p24 antigen as the levels of these two markers are usually very high due to the higher replication of the virus during this period of infection. [1][2][3][4] Higher generations of HIV assays in a routine testing laboratory can aid in the diagnosis of acute HIV infection early in its course. The case reported here illustrates the nuances in the diagnosis of HIV infection for care providers as well as awareness of the unusual seroconversion proÞ le in HIV infection.…”

Section: Abstract: Acute Hiv Infection Hiv; India Seroconversionmentioning

confidence: 99%

An unusual seroconversion profile in a pregnant woman infected with the human immunodeficiency virus-1: Need for using later generations HIV screening assays

Kannangai¹,

Kandathil²,

Daniel³

et al. 2008

Indian J Med Microbiol

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The Þ rst HIV-1 marker that appears in blood following infection is HIV-1 RNA and usually the load is in millions of copies/ ml preceding seroconversion. A 24-year-old pregnant woman, gravida 2, parity 1 was tested for HIV as part of antenatal screening. Three samples were collected and tested from this individual over a period 70 days. The HIV-1 RNA level during seroconversion phase was very low contrary to the well understood natural history of HIV infection. The reactivity rate in the ELISA and the Western Blot proÞ le showed a gradual increase over the 70 days with a weak reactivity in a second generation assay (detects IgG only) for the third sample. This case illustrates the uncertainties regarding the serological window period in HIV infection and the need to use at least a third generation assay in testing centres for early detection of HIV infection.

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“…Während der asymptomatischen Phase kann der Virustiter bis unter 10 2 Genomkopien/ml absinken; aber auch in dieser Phase sind infizierte Personen über Blut und Genitalsekrete infektiös. Ab etwa 11 Tagen kann HIV-RNA im Blut nachweisbar sein [70], ab der zweiten Woche HIV-DNA in BlutLymphozyten [71]. Auch in weißen Blutzellen von HIV-infizierten LTNP (long term non progressors oder sog.…”

Section: Hiv-2unclassified

“…Woche nach Infektion, normalerweise nach 4 bis 5 Wochen, und bei verzögerter Immunantwort nach 8 Wochen, im Plasma HIV-spezifische Antikörper nachweisen (siehe 1.4) [70,71]. Zu Beginn der Infektion sind die IgM-und IgG-Antikörperspiegel niedrigtitrig und hauptsächlich gegen p24 und die Oberflächenglykoproteine gp120 und gp41 gerichtet.…”

Section: Hiv-2unclassified

Humanes Immunschwächevirus (HIV)

Gesundheit¹

2015

Bundesgesundheitsbl.

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Diagnosis of primary HIV-1 infection and duration of follow-up after HIV exposure

Cited by 121 publications

References 16 publications

Selection of drug‐resistant HIV‐1 during the early phase of viral decay is uncommon in treatment‐naïve patients initiated on a three‐ or four‐drug antiretroviral regimen including lamivudine

Selection of drug‐resistant HIV‐1 during the early phase of viral decay is uncommon in treatment‐naïve patients initiated on a three‐ or four‐drug antiretroviral regimen including lamivudine

An unusual seroconversion profile in a pregnant woman infected with the human immunodeficiency virus-1: Need for using later generations HIV screening assays

Humanes Immunschwächevirus (HIV)

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