Antibody detection by agglutination-PCR (ADAP) enables early diagnosis of HIV infection by oral fluid analysis
Antibody detection by agglutination-PCR (ADAP) enables early diagnosis of HIV infection by oral fluid analysis
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DOI：
10.1073/pnas.1711004115
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发表时间：
2018-02-06
影响因子：
11.1
通讯作者：
Bertozzi, Carolyn R.
中科院分区：
文献类型：
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作者：
Tsai, Cheng-ting;Robinson, Peter V.;Bertozzi, Carolyn R.
口服液（OF）是基于人群的HIV筛查工作的一种非常有效的基质，因为它是非传染性的，并且比血液更容易收集。然而，与血液相比，抗HIV抗体在OF中的浓度低得多，导致灵敏度差，从感染到检测阈值的时间较长。因此，尽管OF在样本收集方面具有固有的优势，但它并没有广泛用于人群筛查。在这里，我们报告了一种基于抗体检测凝集-PCR（ADAP）技术的HIV OF检测方法的发展。该检测试剂盒的分析灵敏度是临床酶联免疫检测试剂盒（EIA）的1，000 - 10，000倍，在检测OF样本中的HIV抗体时显示出100%的临床灵敏度和100%的特异性。我们表明，增强的分析灵敏度，使这种检测方法能够正确识别HIV感染者，否则错过了目前的OF检测。我们设想，这种改进的HIV OF测定的属性可以提高高危个体的检测率，同时能够在更早的时间点进行诊断和治疗。
Oral fluid (OF) is a highly effective substrate for population-based HIV screening efforts, as it is noninfectious and significantly easier to collect than blood. However, anti-HIV antibodies are found at far lower concentrations in OF compared with blood, leading to poor sensitivity and a longer period of time from infection to detection threshold. Thus, despite its inherent advantages in sample collection, OF is not widely used for population screening. Here we report the development of an HIV OF assay based on Antibody Detection by Agglutination-PCR (ADAP) technology. This assay is 1,000-10,000 times more analytically sensitive than clinical enzyme-linked immunoassays (EIAs), displaying both 100% clinical sensitivity and 100% specificity for detecting HIV antibodies within OF samples. We show that the enhanced analytical sensitivity enables this assay to correctly identify HIV-infected individuals otherwise missed by current OF assays. We envision that the attributes of this improved HIV OF assay can increase testing rates of at-risk individuals while enabling diagnosis and treatment at an earlier time point.