Diagnostic value of specific IgM antibodies in primary HIV infection

Lange, Jessica; Parry, John; Wolf, Frank de; Mortimer, P P; Goudsmit, Jaap

doi:10.1097/00002030-198802000-00005

Cited by 42 publications

(14 citation statements)

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“…The subjects were then submitted to the second blood drawn for further tests, and were asked to come to a scheduled visit at the Federal University of Sao Paulo within 15 days. Samples were submitted to CD 4 + T lymphocyte counts, and plasma viral load determination.…”

Section: Volunteer Enrollmentmentioning

confidence: 99%

“…After excluding the three patients who did not meet clinical and laboratory criteria for recent infection, the laboratory findings revealed a median CD 4 + T lymphocyte count of 585 cells/µL (inter-quartile range 25%-75% [IQR], 372-754), a CD 8 + T lymphocyte count of 886 cells/µL (IQR, 553-1098), and a viral load of 11,000 HIV-RNA copies/mL (IQR, 3,650-78,150), log 10 of 4.04 (IQR 3.56-4.88).…”

Section: Enrollment and Clinical And Laboratory Characteristics Findingsmentioning

confidence: 99%

“…Patient 2006 had a history of a negative test for HIV antibodies one year before, and a CD 4 + T lymphocyte count of 215 cells/µL, but follow-up evaluations demonstrated increasing numbers (236 and 320 cells/ µL, at 31 and 60 days, respectively, after the first follow-up study visit). Patient 1015 reported a highly suspicious contact before the first HIV antibody testing.…”

Section: Enrollment and Clinical And Laboratory Characteristics Findingsmentioning

confidence: 99%

“…However, no symptoms compatible with primary infection were reported. The first CD 4 + count revealed 146 cells/mL, followed by 121 cells/mL 36 days after, which motivated the initiation of antiretroviral therapy. Table 1.…”

Section: Enrollment and Clinical And Laboratory Characteristics Findingsmentioning

confidence: 99%

“…STARHS is based on the slow increase in antibodies observed during the early period of infection, then reaching a plateau [3][4][5][6]. In the STARHS method, a standard commercial diagnostic EIA is modified to reduce its sensitivity to a point where serum samples with low antibody titers are weakly reactive or negative in the LS assay.…”

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confidence: 99%

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Establishment of the serologic testing algorithm for recent human immunodeficiency virus (HIV) seroconversion (STARHS) strategy in the city of São Paulo, Brazil

Kallas¹,

Bassichetto²,

Oliveira³

et al. 2004

Braz J Infect Dis

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Section: Volunteer Enrollmentmentioning

confidence: 99%

Section: Enrollment and Clinical And Laboratory Characteristics Findingsmentioning

confidence: 99%

Section: Enrollment and Clinical And Laboratory Characteristics Findingsmentioning

confidence: 99%

Section: Enrollment and Clinical And Laboratory Characteristics Findingsmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Establishment of the serologic testing algorithm for recent human immunodeficiency virus (HIV) seroconversion (STARHS) strategy in the city of São Paulo, Brazil

Kallas¹,

Bassichetto²,

Oliveira³

et al. 2004

Braz J Infect Dis

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Markers of HIV Infection Prior to IgG Antibody Seropositivity

Stramer

Heller

Coombs

et al. 1989

JAMA

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During a 1-year period of study at two plasma collection centers, 7 of 35,000 plasma donors seroconverted to the human immunodeficiency virus (HIV) and had stored plasma samples that predated or antedated the seroconversion period. From each donor, three to eight plasma samples that had been collected at 2- to 7-day intervals were tested for IgG and IgM antibodies to HIV with enzyme immunoassays, Western blot testing, and radioimmunoprecipitation assays. The presence of an HIV viremic phase was demonstrated by the infectivity of plasma on normal, phytohemagglutinin-stimulated peripheral blood mononuclear cells and by the detection of HIV antigen. In 5 of these donors, HIV antigen was detected prior to or simultaneously with IgG to HIV; these HIV-antigen-positive samples overlapped an IgM immune response. The disappearance of detectable HIV antigen, and to a lesser extent plasma infectivity, was concurrent with the development of an IgG immune response. Although the improved sensitivity of a recombinant DNA-derived anti-HIV screening assay shortened the "window period" between initial HIV infection and antibody detection, HIV antigen and plasma HIV viremia were the only markers of HIV infection for several days in 2 donors. These results demonstrate that HIV plasma viremia and antigenemia occur prior to seroconversion in healthy plasma donors.

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New Testing Strategy to Detect Early HIV-1 Infection for Use in Incidence Estimates and for Clinical and Prevention Purposes

Janssen

Satten²,

Stramer³

et al. 1998

JAMA

631

491

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Context.-Differentiating individuals with early human immunodeficiency virus 1 (HIV-1) infection from those infected for longer periods is difficult but important for estimating HIV incidence and for purposes of clinical care and prevention.Objective.-To develop and validate a serologic testing algorithm in which HIV-1-positive persons with reactive test results on a sensitive HIV-1 enzyme immunoassay (EIA) but nonreactive results on a less sensitive (LS) EIA are identified as having early infection.Design.-Diagnostic test and testing strategy development, validation, and application. Specimens were tested with both a sensitive HIV-1 EIA (3A11 assay) and a less sensitive modification of the same EIA (3A11-LS assay).Settings and Participants.-For assay development: 104 persons seroconverting to HIV-1 comprising 38 plasma donors, 18 patients of a sexually transmitted disease clinic in Trinidad, and 48 participants in the San Francisco Men's Health Study (SFMHS); 268 men without the acquired immunodeficiency syndrome (AIDS) in the SFMHS who had been infected for at least 2.5 years; and 207 persons with clinical AIDS; for testing strategy validation: 488 men in the SFMHS from 1985 through 1990 and 1 275 449 repeat blood donors at 3 American Red Cross blood centers from 1993 through 1995; and for HIV-1 incidence estimates: 2 717 910 first-time blood donors. We retrospectively identified persons eligible for a study of early infection.Main Outcome Measure.-Ability to identify early HIV infection. Results.-Estimated mean time to being 3A11 reactive/3A11-LS nonreactive was 129 days (95% confidence interval [CI], 109-149 days). Our testing strategy accurately diagnosed 95% of persons with early infection; however, 0.4% (1/268) of men with established infection and 2% (5/207) of persons with late-stage AIDS were misdiagnosed as having early HIV-1 infection. Average yearly incidence estimates in SFMHS subjects were 1.5% per year vs observed average incidence of 1.4 per 100 person-years. Incidence in repeat blood donors using the sensitive/less sensitive assay testing strategy was 2.95 per 100 000 per year (95% CI, 1.14-6.53/ 100 000) vs observed incidence of 2.60 per 100 000 person-years (95% CI, 1.49-4.21/100 000). Overall incidence in first-time blood donors was 7.18 per 100 000 per year (95% CI, 4.51-11.20/100 000) and did not change statistically significantly between 1993 and 1996. Use of the sensitive/less sensitive testing strategy alone would have identified all 17 persons with antibodies to HIV-1 eligible for a study of early HIV-1 infection and would have increased enrollment.Conclusions.-The sensitive/less sensitive testing strategy provides accurate diagnosis of early HIV-1 infection, provides accurate estimates of HIV-1 incidence, can facilitate clinical studies of early HIV-1 infection, and provides information on HIV-1 infection duration for care planning.

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Diagnostic value of specific IgM antibodies in primary HIV infection

Cited by 42 publications

References 0 publications

Establishment of the serologic testing algorithm for recent human immunodeficiency virus (HIV) seroconversion (STARHS) strategy in the city of São Paulo, Brazil

Establishment of the serologic testing algorithm for recent human immunodeficiency virus (HIV) seroconversion (STARHS) strategy in the city of São Paulo, Brazil

Markers of HIV Infection Prior to IgG Antibody Seropositivity

New Testing Strategy to Detect Early HIV-1 Infection for Use in Incidence Estimates and for Clinical and Prevention Purposes

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