Quantification of HIV-1 p24 by a highly improved ELISA:: An alternative to HIV-1 RNA based treatment monitoring in patients from Abidjan, Cote d'Ivoire
Quantification of HIV-1 p24 by a highly improved ELISA:: An alternative to HIV-1 RNA based treatment monitoring in patients from Abidjan, Cote d'Ivoire
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DOI：
10.1016/j.jcv.2006.08.005
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发表时间：
2006-11-01
影响因子：
8.8
通讯作者：
Boeni, Juerg
中科院分区：
文献类型：
--
作者：
Tehe, Andre;Maurice, Chantal;Boeni, Juerg
背景：HIV-1 RNA的定量在非洲仍然难以实施。抗逆转录病毒治疗（ART）监测需要简单和廉价的测试。目的：在西非环境中评估HIV-1 p24 ELISA，该ELISA结合了有效的病毒破坏，热变性和信号放大。对来自科特迪瓦阿比让的86名HIV-1感染患者进行了基线p24、HIV-1 RNA和CD 4+计数检测，结果：所有患者在首次随访时对抗逆转录病毒治疗有反应，HIV-1 RNA最小下降0.5 log（10）。41例（47.7%）随后反弹>0.5 log（10）或在第24周时持续高于1000拷贝/mL。对应于100，000拷贝/mL HIV-1 RNA的p24的预测基线浓度（高于该浓度时推荐ART）为4546 fg/mL（95%置信区间3148-6566）。病毒学失败的预测模型，发生在对ART的初步反应后，正确分类84%的患者使用基线p24，p24治疗的变化，和实现不可检测的p24作为解释变量。该模型和进一步的自举评估表明，一个很好的能力来区分持续或失败的病毒学反应ART。结论：HIV-1 p24和RNA为基础的ART监测在一个低资源的国家为主的HIV-1 CRF 02 AG出现可比。(C)2006 Elsevier B. V.保留所有权利。
Background: Quantification of HIV-1 RNA remains difficult to implement in Africa. Simple and inexpensive tests for antiretroviral treatment (ART) monitoring are needed.Objective: To evaluate an HIV-1 p24 ELISA, which combines efficient virus disruption, heat-denaturation and signal amplification, in a West African setting.Study design: Eighty-six HIV-1 infected patients from Abidjan, Me d'Ivoire, were tested for p24, HIV-1 RNA, and CD4+ count at baseline, and twice within 8 months after ART initiation.Results: All patients responded to ART with a minimal HIV-1 RNA drop of 0.5 log(10) at first follow-up. Forty-one (47.7%) then rebounded >0.5 log(10) or persisted above 1000 copies/mL by week 24. The predicted baseline concentration of p24 corresponding to 100,000 copies/mL of HIV-1 RNA, above which ART is recommended, was 4546 fg/mL (95% confidence interval 3148-6566). A prediction model of virologic failure, occurring after an initial response to ART, correctly classified 84% of patients using baseline p24, p24 change on therapy, and achievement of undetectable p24 as explanatory variables. The model and further bootstrap evaluation suggested a good ability to discriminate between sustained or failing virologic response to ART.Conclusion: HIV-1 p24 and RNA based-ART monitoring in a low-resource country dominated by HIV-1 CRF02 AG appeared comparable. (C) 2006 Elsevier B.V. All rights reserved.