Field evaluation of an improved assay using a heat-dissociated p24 antigen for adults mainly infected with HIV-1CRF02_AG strains in Cote d'Ivoire, West Africa
Field evaluation of an improved assay using a heat-dissociated p24 antigen for adults mainly infected with HIV-1CRF02_AG strains in Cote d'Ivoire, West Africa
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DOI：
10.1097/00126334-200311010-00002
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发表时间：
2003-11-01
影响因子：
3.6
通讯作者：
Rouzioux, C
中科院分区：
文献类型：
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作者：
Bonard, D;Rouet, F;Rouzioux, C
本研究的目的是评价热解离p24抗原（HD p24 Ag）检测作为一种替代的低成本工具，用于诊断HIV-1感染和定量HIV-1 RNA水平，主要感染HIV-1 CRF02_AG毒株的非洲成年人。从入组ANRS 1220 PRIMO-CI队列（阿比让，科特迪瓦，西非）的HIV-1血清阳性受试者中获得117份血浆标本。HD p24 Ag检测试剂盒的结果与Amplicor HIV-1 Monitor检测试剂盒（1.5版; Roche Diagnostics，Indianapolis，IN）在相同抗体阳性血浆样本中定量测定的HIV-1 RNA水平结果相当：灵敏度分别为95.7%和96.6%;特异性（使用75例血清阴性受试者的样本进行评价）分别为94.7%和100%。HD p24 Ag和HIV-1 RNA检测呈弱相关（斯皮尔曼相关系数，r = 0.33; P < 0.001），但HIV-1 RNA水平大于或等于5 log（10）拷贝/mL（r = 0.62; P < 0.001）除外。从14例接受高效抗逆转录病毒治疗的患者中获得的76份血浆标本中，HD p24抗原血症的定量显示治疗期间的变化弱于HIV-1 RNA检测。使用这两种标记物对感染患者进行的随访显示了不同的结果。HD p24 Ag检测试剂盒作为测量非洲HIV-1 RNA水平的替代工具在临床和生物学管理方面的可靠性值得怀疑。
The aim of this study was to evaluate the heat-dissociated p24 antigen (HD p24 Ag) assay as an alternative low-cost tool for diagnosis of HIV-1 infection and quantitation of HIV-1 RNA levels in African adults mainly infected with HIV-1 CRF02_AG strains. One hundred seventeen plasma specimens were obtained from HIV-1-seropositive subjects enrolled in the ANRS 1220 PRIMO-CI cohort (Abidjan, Cote d'lvoire, West Africa). Results of the HD p24 Ag assay were comparable with those of HIV-1 RNA levels quantified in the same antibody-positive plasma samples by the Amplicor HIV-1 Monitor assay (1.5 version; Roche Diagnostics, Indianapolis, IN): sensitivity, 95.7% versus 96.6%, respectively; specificity (evaluated with samples from 75 seronegative subjects), 94.7% versus 100%, respectively. HD p24 Ag and HIV-1 RNA assays were weakly correlated (Spearman coefficient correlation, r = 0.33; P < 0.001) except for HIV-1 RNA levels of greater than or equal to5 log(10) copies/mL (r = 0.62; P < 0.001). Quantitation of HD p24 antigenemia in 76 plasma specimens from 14 patients treated with highly active antiretroviral therapy demonstrated weaker changes during treatment than those observed with the HIV-1 RNA assay. Follow-up of infected patients using both markers showed different results. The reliability of the HD p24 Ag assay is questionable for clinical and biologic management as a surrogate tool for measurement of HIV-1 RNA levels in Africa.