Better control of early viral replication is associated with slower rate of elicited antiviral antibodies in the detuned enzyme immunoassay during primary HIV-1C infection

Vladimir Novitsky, Rui Wang, Lemme Kebaabetswe, Jamieson Greenwald, Raabya Rossenkhan, Sikhulile Moyo, Rosemary Musonda, Elias Woldegabriel, Stephen Lagakos, M. Essex

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

BACKGROUND: Estimation of HIV incidence rates is important for timing interventions, planning prevention studies, and monitoring the epidemic. This requires accurate estimation of the "recency period" (also known as the "window period") between seroconversion and achievement of specific detectable levels of anti-HIV antibody titers, such as the standardized optical density (SOD) in the early phase of HIV-1 infection. METHODS: To obtain a better understanding of interpatient variation of the recency period, prospective measurements of antiviral antibody titers in the early phase of HIV-1 subtype C infection were quantified by Vironostika-LS. Time of seroconversion was estimated by Fiebig staging. RESULTS: The profiles of SOD values during the first year of infection commonly showed slow initial increase followed by a more rapid increase, although in some patients, SOD values increased rapidly soon after seroconversion. Using an SOD cutoff of 1.0, the average duration of the recency period in subtype C infection in the local epidemic in Botswana was estimated to be 151 days (95% confidence interval: 130 to 172 days) post seroconversion. The recency period was significantly associated (P = 0.007) with the level of viral replication during the first 2-3 months post seroconversion. Reduction of SOD values after initiation of antiretroviral therapy (ART) was a dominant pattern in antiretroviral drug (ARV)-treated subjects. CONCLUSIONS: Our data suggest that HIV incidence estimation based on sensitive/less sensitive enzyme immunoassay cross-sectional testing could be potentially improved by incorporation of viral load levels at the time of detection of a recent infection.

Original languageEnglish
Pages (from-to)265-272
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume52
Issue number2
DOIs
Publication statusPublished - 2009

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Immunoenzyme Techniques
HIV Infections
Antiviral Agents
Antibodies
Infection
HIV-1
HIV
Botswana
HIV Antibodies
Incidence
Viral Load
Anti-Idiotypic Antibodies
Seroconversion
Confidence Intervals
Pharmaceutical Preparations
Therapeutics

All Science Journal Classification (ASJC) codes

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Novitsky, Vladimir ; Wang, Rui ; Kebaabetswe, Lemme ; Greenwald, Jamieson ; Rossenkhan, Raabya ; Moyo, Sikhulile ; Musonda, Rosemary ; Woldegabriel, Elias ; Lagakos, Stephen ; Essex, M. / Better control of early viral replication is associated with slower rate of elicited antiviral antibodies in the detuned enzyme immunoassay during primary HIV-1C infection. In: Journal of Acquired Immune Deficiency Syndromes. 2009 ; Vol. 52, No. 2. pp. 265-272.
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Better control of early viral replication is associated with slower rate of elicited antiviral antibodies in the detuned enzyme immunoassay during primary HIV-1C infection. / Novitsky, Vladimir; Wang, Rui; Kebaabetswe, Lemme; Greenwald, Jamieson; Rossenkhan, Raabya; Moyo, Sikhulile; Musonda, Rosemary; Woldegabriel, Elias; Lagakos, Stephen; Essex, M.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 52, No. 2, 2009, p. 265-272.

Research output: Contribution to journalArticle

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T1 - Better control of early viral replication is associated with slower rate of elicited antiviral antibodies in the detuned enzyme immunoassay during primary HIV-1C infection

AU - Novitsky, Vladimir

AU - Wang, Rui

AU - Kebaabetswe, Lemme

AU - Greenwald, Jamieson

AU - Rossenkhan, Raabya

AU - Moyo, Sikhulile

AU - Musonda, Rosemary

AU - Woldegabriel, Elias

AU - Lagakos, Stephen

AU - Essex, M.

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Estimation of HIV incidence rates is important for timing interventions, planning prevention studies, and monitoring the epidemic. This requires accurate estimation of the "recency period" (also known as the "window period") between seroconversion and achievement of specific detectable levels of anti-HIV antibody titers, such as the standardized optical density (SOD) in the early phase of HIV-1 infection. METHODS: To obtain a better understanding of interpatient variation of the recency period, prospective measurements of antiviral antibody titers in the early phase of HIV-1 subtype C infection were quantified by Vironostika-LS. Time of seroconversion was estimated by Fiebig staging. RESULTS: The profiles of SOD values during the first year of infection commonly showed slow initial increase followed by a more rapid increase, although in some patients, SOD values increased rapidly soon after seroconversion. Using an SOD cutoff of 1.0, the average duration of the recency period in subtype C infection in the local epidemic in Botswana was estimated to be 151 days (95% confidence interval: 130 to 172 days) post seroconversion. The recency period was significantly associated (P = 0.007) with the level of viral replication during the first 2-3 months post seroconversion. Reduction of SOD values after initiation of antiretroviral therapy (ART) was a dominant pattern in antiretroviral drug (ARV)-treated subjects. CONCLUSIONS: Our data suggest that HIV incidence estimation based on sensitive/less sensitive enzyme immunoassay cross-sectional testing could be potentially improved by incorporation of viral load levels at the time of detection of a recent infection.

AB - BACKGROUND: Estimation of HIV incidence rates is important for timing interventions, planning prevention studies, and monitoring the epidemic. This requires accurate estimation of the "recency period" (also known as the "window period") between seroconversion and achievement of specific detectable levels of anti-HIV antibody titers, such as the standardized optical density (SOD) in the early phase of HIV-1 infection. METHODS: To obtain a better understanding of interpatient variation of the recency period, prospective measurements of antiviral antibody titers in the early phase of HIV-1 subtype C infection were quantified by Vironostika-LS. Time of seroconversion was estimated by Fiebig staging. RESULTS: The profiles of SOD values during the first year of infection commonly showed slow initial increase followed by a more rapid increase, although in some patients, SOD values increased rapidly soon after seroconversion. Using an SOD cutoff of 1.0, the average duration of the recency period in subtype C infection in the local epidemic in Botswana was estimated to be 151 days (95% confidence interval: 130 to 172 days) post seroconversion. The recency period was significantly associated (P = 0.007) with the level of viral replication during the first 2-3 months post seroconversion. Reduction of SOD values after initiation of antiretroviral therapy (ART) was a dominant pattern in antiretroviral drug (ARV)-treated subjects. CONCLUSIONS: Our data suggest that HIV incidence estimation based on sensitive/less sensitive enzyme immunoassay cross-sectional testing could be potentially improved by incorporation of viral load levels at the time of detection of a recent infection.

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