Feasibility of pooling sera for HIV-1 viral RNA to diagnose acute primary HIV-1 infection and estimate HIV incidence
Feasibility of pooling sera for HIV-1 viral RNA to diagnose acute primary HIV-1 infection and estimate HIV incidence
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DOI：
10.1097/00002030-200012010-00015
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发表时间：
2000-12-01
期刊：
影响因子：
3.8
通讯作者：
Bollinger, R
中科院分区：
文献类型：
--
作者：
Quinn, TC;Brookmeyer, R;Bollinger, R
目的：开发一个汇集的方法检测病毒RNA的诊断急性HIV感染和估计HIV-1 incidence.Methods：从700连续血清阴性患者参加性传播疾病诊所在印度浦那，分别筛选p24抗原，并汇集成7池的100检测HIV-1 RNA的逆转录-聚合酶链反应。HIV-1的发病率计算传统的队列方法，p24抗原的方法，和一个多阶段的汇集方法，其中RNA阳性池重新分析在较小的pools.Results：从700个人的血清被分为7池100，其中4个是阳性的。这4个阳性样本池被细分为8个样本池，每个样本池50个样本，其中7个样本池为阳性。将7个阳性池细分为35个池，每个池10个，其中10个为阳性。基于10个RNA阳性样本池，HIV-1发病率的点估计值为每年19.9%[95%置信区间（CI），7.3-31.8%]。在700份p24抗原分析样本中，8份为阳性，导致发生率的点估计值为18.5%/年（8.0-36.5%）。相比之下，由于随访率较低，基于传统队列随访方法的发生率较低，为9.4%/年（4.8-16.4%）。对10份RNA阳性混合物的单个样本进行检测，确定10名急性原发性HIV-1感染者。结论：多阶段混合法检测HIV-1 RNA的灵敏度高于p24抗原法，且比p24抗原法便宜5倍。合并样本进行RNA检测可有效估计目前的发病率，节省成本，可在发展中国家实际使用。(C)2000年利平科特威廉姆斯&威尔金斯。
Objective: To develop a pooling method for detection of viral RNA for diagnosis of acute HIV infection and estimation of HIV-1 incidence.Methods: Sera from 700 consecutive seronegative patients attending sexually transmitted disease clinics in Pune, India, were screened individually for p24 antigen, and pooled into seven pools of 100 for detection of HIV-1 RNA by reverse transcriptase-polymerase chain reaction. HIV-1 incidence was calculated by the traditional cohort method, the p24 antigen method, and a multistage pooling method in which RNA-positive pools were re-analyzed in smaller pools.Results: Sera from 700 individuals were grouped into seven pools of 100, of which four were positive. These four positive pools were subdivided into eight pools of 50, of which seven were positive. The seven positive pools were subdivided into 35 pools of 10, of which 10 were positive. Based on the 10 RNA-positive pools, the point estimate of HIV-1 incidence was 19.9% per year [95% confidence interval (CI), 7.3-31.8%]. Of the 700 samples analyzed for p24 antigen, eight were positive, resulting in a point estimate of incidence of 18.5%/year (8.0-36.5%). In contrast, the incidence rate based on the traditional cohort method of follow-up was lower at 9.4%/year (4.8-16.4%) due to a low follow-up rate. Testing of individual samples from the 10 RNA-positive pools identified 10 individuals with acute primary HIV-1.Conclusion: The multistage pooling method for detection of HIV-1 RNA was more sensitive than the p24 antigen method, and was five-fold less expensive than the p24 antigen assays. Pooling samples for RNA detection was effective in estimating current incidence rates with cost savings that would be practical for use in developing countries. (C) 2000 Lippincott Williams & Wilkins.