scholarly journals Characterization of New HIV Infections among Adults ≥45 Years—New York City, North Carolina, San Francisco, 2011–2013

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S15-S15
Author(s):  
Mary Evans ◽  
Anne Patala ◽  
Ellsworth Campbell ◽  
Emily Westheimer ◽  
Cynthia L Gay ◽  
...  
Keyword(s):  
Older Adults ◽  
Hiv Prevention ◽  
Hiv Infection ◽  
San Francisco ◽  
Acute Infection ◽  
Study Participant ◽  
Rapid Test ◽  
Bivariate Analysis ◽  
Similar Frequency ◽  
Hiv 1

Abstract Background While HIV prevention activities are often focused on younger people, older people can also be at risk for HIV infection. We aimed to characterize HIV transmission in older adults. Methods The STOP study was a multi-site prospective study of persons with acute HIV infection (AHI) from 2011 to 2013. Older adults were defined as ≥45 years and younger persons were 13–44 years. AHI was defined by a negative rapid test but a reactive antigen/antibody or HIV RNA test. We performed bivariate analysis using Pearson’s chi-square and odds ratios to examine associations between older age and transmission characteristics. Among persons with HIV-1 polymerase (pol) sequences, transmission linkages were inferred when the genetic distance between sequences was <1.5% and did not indicate directionality of transmission. Results Among 86,836 participants (median age, 29 years; 75.0% male; 51.8% MSM), HIV infection was diagnosed in 176 (1.46%) of 12,036 older adults compared with 1,150 (1.53%) of 74,800 younger people (P = 0.56). Among HIV-infected persons, AHI was diagnosed in similar proportions of older and younger people (13.1% vs. 12.6%; P = 0.86). Among HIV-infected persons who participated in partner notification (n = 1,326), older adults were less likely to report meeting a sex partner online (11.3% vs. 26.9%; OR 0.52, 95% CI = 0.35–0.78) and were less likely to name ≥2 sex partners (31.5% vs. 46.8%; OR = 0.28, 95% CI = 0.15–0.53) compared with younger people. Among HIV-infected persons with HIV-1 pol sequences (n = 537), similar proportions of older and younger people had viruses that genetically linked with another study participant (15.9% vs. 23.5%; OR 0.62, 95% CI 0.31–1.22) (Figure). Conclusion In this study, older adults had a similar frequency of newly diagnosed HIV infection, acute infection, and genetic linkage compared with younger people, suggesting that increased HIV prevention efforts may be needed in this population. Disclosures All authors: No reported disclosures.

The performance of the Alere HIV combo point-of-care test on stored serum samples; useful for detection of early HIV-1 infections?

2017 ◽  
Vol 94 (5) ◽  
pp. 331-333 ◽  
Author(s):  
Carla van Tienen ◽  
Sharona Rugebregt ◽  
Sandra Scherbeijn ◽  
Hannelore Götz ◽  
Corine Geurts van Kessel
Keyword(s):  
Hiv Infection ◽  
Point Of Care ◽  
Acute Infection ◽  
Rapid Test ◽  
Public Health Department ◽  
Laboratory Setting ◽  
Serum Samples ◽  
Point Of Care Test ◽  
P24 Antigen ◽  
Hiv 1

IntroductionThe Alere HIV-1/2 Antigen/Antibody Combo point-of-care test is a commercially available 4th-generation rapid test for the diagnosis of HIV infection, including acute infection. We evaluated the sensitivity of this test in samples from patients with acute, recent or chronic HIV-1 infection.MethodsA validation of the test was performed using 89 HIV-positive serum samples collected in 2008–2016, that were stored at −20°C. Twenty-three samples were only p24-positive (acute infection); 49 samples were antibody-positive and p24-positive (recent infection); 17 samples were only antibody-positive (chronic infection). HIV infection was confirmed by standard-of-care assays and PCR. Samples came from patients attending an outpatient clinic for STDs at the Public Health Department and from patients within the Erasmus Medical Center, Rotterdam, the Netherlands.ResultsThe overall sensitivity of the test for diagnosing HIV infection based on detection of p24 antigen and/or antibodies was 92% (95% CI 86% to 98%) (82/89). In acute sera with only p24 antigen positivity, the sensitivity of the test decreased to 65% (95% CI 46% to 85%) (15/23). When both antibody and antigen testing were positive, the p24 sensitivity was only 24% (95% CI 12% to 36%) (12/49), but in these sera the final test result was positive in all sera (49/49) due to the positive antibody component.ConclusionsIn a laboratory setting, this test has an overall sensitivity of 92% to detect any stage of HIV-1 infection using sera specimens. It performs relatively well in detecting early HIV and may be beneficial as an initial screening in patients with a recent exposure to HIV. Additional testing in a laboratory setting remains mandatory as a proportion of acute HIV-1 infections are missed with this test.

scholarly journals Evaluation of the Bio-Rad Geenius HIV 1/2 Assay as Part of a Confirmatory HIV Testing Strategy for Quebec, Canada: Comparison with Western Blot and Inno-Lia Assays

2019 ◽  
Vol 57 (6) ◽  
Author(s):  
Bouchra Serhir ◽  
Céline Desjardins ◽  
Florence Doualla-Bell ◽  
Marc Simard ◽  
Cécile Tremblay ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Western Blot ◽  
Hiv Testing ◽  
Rapid Test ◽  
Testing Strategy ◽  
Blood Samples ◽  
Confirmatory Assay ◽  
Hiv 1 ◽  
Hiv Negative ◽  
Specificity Rate

ABSTRACT The rapid confirmatory Bio-Rad Geenius HIV 1/2 assay was evaluated as an alternative to the HIV-1 Western blot (WB) confirmatory assay. A total of 370 retrospective samples collected from 356 patients were tested. Sensitivity of the Geenius assay to detect HIV-1 and HIV-2 infections was 100% and 97%, respectively, and that of the WB assay was 86% and 39%, respectively. Geenius reduced the number of indeterminate results by 85% and exhibited a differentiation capacity for HIV-1 and HIV-2 of 100% and 89%, respectively. Three of 10 patients presenting with an early HIV infection (1 to 2 weeks before seroconversion by WB) were positive using Geenius. None of the HIV-negative samples were positive using Geenius or WB. However, 7% and 10% of them were indeterminate with Geenius and WB, respectively, leading to a specificity rate of 93% for Geenius and 90% for WB. Ninety cadaveric samples (54 negative, 23 HIV-1 positive, and 3 HIV-1 indeterminate) were tested with Geenius, leading to a sensitivity of 100%, a specificity of 96%, and an indeterminate rate of 4%. Our results indicate that the Bio-Rad Geenius HIV 1/2 rapid test exhibits better sensitivity to detect HIV-1 infections and better performance than WB to confirm and differentiate between HIV-1 and HIV-2 infections. The performance of this new confirmatory assay to detect early infections, to reduce the rate of indeterminate status, and to confirm HIV-1 infection in cadaveric blood samples makes Geenius a potent reliable alternative to the WB.

scholarly journals Viral Loads Within 6 Weeks After Diagnosis of HIV Infection in Early and Later Stages: Observational Study Using National Surveillance Data (Preprint)

2018 ◽  
Author(s):  
Richard M. Selik ◽  
Laurie Linley
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
Acute Infection ◽  
Antibody Test ◽  
Case Definition ◽  
Positive Test ◽  
Median Viral Load ◽  
Acute Hiv Infection ◽  
Viral Loads ◽  
Hiv 1

BACKGROUND Early (including acute) HIV infection is associated with viral loads higher than those in later stages. OBJECTIVE This study aimed to examine the association between acute infection and viral loads near the time of diagnosis using data reported to the US National HIV Surveillance System. METHODS We analyzed data on infections diagnosed in 2012-2016 and reported through December 2017. Diagnosis and staging were based on the 2014 US surveillance case definition for HIV infection. We divided early HIV-1 infection (stage 0) into two subcategories. Subcategory 0α: a negative or indeterminate HIV-1 antibody test was ≤60 days after the first confirmed positive HIV-1 test or a negative or indeterminate antibody test or qualitative HIV-1 nucleic acid test (NAT) was ≤180 days before the first positive test, the latter being a NAT or detectable viral load. Subcategory 0β: a negative or indeterminate antibody or qualitative NAT was ≤180 days before the first positive test, the latter being an HIV antibody or antigen/antibody test. We compared median earliest viral loads for each stage and subcategory in each of the first 6 weeks after diagnosis using only the earliest viral load for each individual. RESULTS Of 203,392 infections, 56.69% (115,297/203,392) were reported with a quantified earliest viral load within 6 weeks after diagnosis and criteria sufficient to determine the stage at diagnosis. Among 5081 infections at stage 0, the median earliest viral load fell from 694,000 copies/mL in week 1 to 125,022 in week 2 and 43,473 by week 6. Among 30,910 infections in stage 1, the median earliest viral load ranged 15,412-17,495. Among 42,784 infections in stage 2, the median viral load declined from 44,973 in week 1 to 38,497 in week 6. Among 36,522 infections in stage 3 (AIDS), the median viral load dropped from 205,862 in week 1 to 119,000 in week 6. The median earliest viral load in stage 0 subcategory 0α fell from 1,344,590 copies/mL in week 1 to 362,467 in week 2 and 47,320 in week 6, while that in subcategory 0β was 70,114 copies/mL in week 1 and then 32,033 to 44,067 in weeks 2-6. The median viral load in subcategory 0α was higher than that in subcategory 0β in each of the first 6 weeks after diagnosis (P<.001). CONCLUSIONS In the 1st week after diagnosis, viral loads in early infections are generally several times higher than those in later stages at diagnosis. By the 3rd week, however, most are lower than those in stage 3. High viral loads in early infection are much more common in subcategory 0α than in subcategory 0β, consistent with 0α comprising mostly acute infections and 0β comprising mostly postacute early infections. These findings may inform the prioritization of interventions for prevention.

scholarly journals Absence of routine molecular testing and prevalence of HIV-2 infection in regions hardest-hit by HIV infection

2012 ◽  
Vol 6 (12) ◽  
pp. 854-859 ◽  
Author(s):  
Joseph C Forbi ◽  
Mathew D Esona ◽  
Hellen O Iperepolu ◽  
Moses P Adoga ◽  
Simon M Agwale
Keyword(s):  
Hiv Infection ◽  
Sex Workers ◽  
False Negative ◽  
Rapid Test ◽  
Molecular Testing ◽  
Test Results ◽  
Active Population ◽  
Hiv Test ◽  
In Series ◽  
Hiv 1

Introduction: Investigating the incidence and dynamics of HIV-2 and false-negative HIV test results in a highly sexually active population where frequent opportunities exist for acquiring and transmitting infections provides additional understanding of the epidemiology of the virus in Africa. Methodology: The HIV status of 900 active female sex workers (FSWs) was determined using two lateral flow rapid assays in series. The second rapid test device incorporates type-specific recombinant peptides that discriminate between HIV-1 and HIV-2 infection. HIV sero-negative samples were re-tested for HIV infection and their viral loads determined using the NucliSENS real-time nucleic acid sequence-based amplification (NASBA) platform. Results: In total, 335 FSWs were determined to be HIV positive, the majority (227; 67.8%) of whom were between the ages of 20 and 30 years. Eighteen (5.4%) were found to have evidence of HIV-2 infection, 17 of whom were co-infected with HIV-1. Only one HIV-2 mono-infection was observed. Out of 565 HIV-negative individuals determined by serology, 11(1.9%; p>0.05) were found to be HIV-1 positive when tested via the NASBA platform. Conclusion: False negative test results, HIV-2 infection, and complex transmission networks among FSWs may aid in fueling the HIV epidemic in the Nigerian population. These findings demonstrate the need to reevaluate the quality of HIV serological diagnostics, control services, and stress the need for widespread introduction of molecular testing among high-risk populations in the country.

Use of rapid HIV testing in a low threshold centre in Antwerp, Belgium, 2007–2012

2014 ◽  
Vol 25 (13) ◽  
pp. 936-942 ◽  
Author(s):  
Kristien Wouters ◽  
Katrien Fransen ◽  
Greet Beelaert ◽  
Chris Kenyon ◽  
Tom Platteau ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Venous Blood ◽  
Rapid Test ◽  
Risk Groups ◽  
Sti Testing ◽  
Rapid Tests ◽  
Low Threshold ◽  
Blood Specimens ◽  
Sex With Men ◽  
Hiv 1

The Antwerp Helpcenter is a low threshold screening centre for HIV and STI testing focused on high-risk groups. The aim of this work is to describe our experience with the use of rapid HIV tests including the analysis of the characteristics of new cases of HIV infection. We performed a retrospective analysis of all rapid tests routinely performed at the Helpcenter in the period June 2007 to December 2012. The Determine®HIV-1/2 (3rd generation) was used until May 2009 and thereafter the Determine Combo®HIV-1/2 Ag/Ab (Alere) test (4th generation) on venous blood. All reactive tests were confirmed using a standard confirmation algorithm with ELISAs and a confirmation test (INNO-LIA HIVI/II Score®). In all, 5025 rapid tests were performed on blood specimens of 3881 clients including 1173 men having sex with men and 454 migrants from sub-Sahara Africa. The overall prevalence of HIV infection was 1.5% and higher among the risk groups: 4.0% of men having sex with men and 2.2% of migrants from sub-Sahara Africa. The availability of a rapid test was an important reason to present at the Helpcenter. The rapid test was successfully introduced into an outpatient testing centre. Client satisfaction with RT was high and most clients were successfully linked to care.

scholarly journals HLA-B*44 allele associated with clinical parameters in HIV-1 infected Moroccan cohort

2019 ◽  
Vol 7 (4) ◽  
pp. 1354
Author(s):  
Fatima Youssoufi ◽  
Hicham El Annaz ◽  
Abdelilah Laraqui ◽  
Reda Tagajdid ◽  
Rachid Abi ◽  
...  
Keyword(s):  
T Cell ◽  
Hiv Infection ◽  
Human Leukocyte ◽  
Cd4 T Cell ◽  
Bivariate Analysis ◽  
Clinical Parameters ◽  
Hiv Viral Load ◽  
Cell Counts ◽  
Pre Treatment ◽  
Hiv 1

Background: The human leukocyte antigen-B*44 (HLA-B*44) allele has been reported to have promising results in the control of human immunodeficiency virus-1 (HIV-1) infection and associated with protection against HIV-1 disease progression. In the Moroccan HIV-1 infected patients, the contribution of this allele has not been established. This study aimed to evaluate the distribution of HLA-B*44 allele among HIV-1-infected in Morocco. Additionally, investigate HLA-B*44 allele association with demographical and HIV clinical parameters.Methods: One hundred and sixty-seven HIV-1 infected, antiretroviral naive individuals were enrolled in this study. The HLA-B*44 allele screening was performed using the PCR amplification.Results: Of the 167 individuals genotyped, 26 (16%) of them expressing the HLA-B*44 allele. Clinical stages at diagnosis, median pre-treatment HIV viral load (pVL) and CD4 T cell counts differ significantly (p = 0.0001, p=0.001 and p=0.0001 respectively) between the patients who had been expressing the HLA-B*44 allele and patients who had not been expressing this allele. The presence of HLA-B*44 allele was significantly associated with pVL and CD4 T cell counts (p=0.004 and p=0.0001 respectively). The bivariate analysis has showed that the expression of the HLA-B*44 allele was strongly associated with advanced HIV infection (Odd ratio (OR) 0.12 (95% confidence interval (CI) 0.04-0.37), p=0.0001).Conclusions: Author have described for the first time in Morocco the association of the HLA-B*44 allele with the clinical parameters of HIV infection. These results expand the knowledge of the distribution and effect of this allele in the Moroccan population.

scholarly journals Comparative evaluation of the Geenius™ HIV 1/2 Confirmatory Assay and the HIV-1 and HIV-2 Western blots in the Japanese population

2018 ◽  
Author(s):  
Makiko Kondo ◽  
Koji Sudo ◽  
Takako Sano ◽  
Takuya Kawahata ◽  
Ichiro Itoda ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Acute Infection ◽  
Screening Tests ◽  
Western Blots ◽  
Suitable Alternative ◽  
Confirmatory Assay ◽  
Testing Algorithm ◽  
Positive Results ◽  
Hiv 1

AbstractAccurate diagnosis of earlier HIV infection is essential for treatment and prevention. Currently, confirmation tests of HIV infection in Japan are performed using Western blot (WB), but WB has several limitations including low sensitivity and cross-reactivity between HIV-1 and HIV-2 antibodies. To address these problems, a new HIV testing algorithm and a more reliable confirmation and HIV-1/2 differentiation assay are required. The Bio-Rad Geenius™ HIV-1/2 Confirmatory Assay (Geenius) has recently been approved and recommended for use in the revised guidelines for diagnosis of HIV infection by the Center for Disease Control and Prevention (USA). We made comprehensive comparison of the performance of Geenius and the Bio-Rad NEW LAV BLOT 1 and 2 (NLB 1 and 2) which are WB kits for HIV-1 and HIV-2, respectively, to examine if Geenius is a suitable alternative to these WB assays which are now being used in HIV testing in Japan. A total of 166 HIV-1 positive samples (146 from patients with established HIV-1 infection and 20 from patients with acute infection), five HIV-1 seroconversion panels containing 21 samples and 30 HIV-2 positive samples were used. In addition, a total of 140 HIV negative samples containing 10 false-positives on screening tests were examined. The sensitivity of Geenius and NLB 1 for HIV-1 positive samples was 99.3% and 98.6%, respectively. Geenius provided more positive results in the samples from acute infections and detected positivity 0 to 32 days earlier in seroconversion panels than NLB 1. NLB 2 gave positive results in 12.3% of HIV-1 positive samples. The sensitivity of both Geenius and NLB 2 for HIV-2 positive samples was 100%. The specificity of Geenius, NLB 1 and NLB 2 was 98.5%, 81.5% and 90.0%, respectively. Geenius is an attractive alternative to WB for confirmation and differentiation of HIV-1 and HIV-2 infections. The adaptation of Geenius to the HIV testing algorithm may be advantageous for rapid diagnosis and the reduction of testing costs.

Evaluation of the Bio-Rad Multispot HIV-1/HIV-2 Rapid Test as an alternative to Western blot for confirmation of HIV infection

2013 ◽  
Vol 58 ◽  
pp. e97-e103 ◽  
Author(s):  
Ana María Cárdenas ◽  
Eleonore Baughan ◽  
Richard L. Hodinka
Keyword(s):  
Hiv Infection ◽  
Western Blot ◽  
Rapid Test ◽  
Hiv 1

scholarly journals Sex Differences in Primary HIV Infection: Revisiting the Role of TLR7-Driven Type 1 IFN Production by Plasmacytoid Dendritic Cells in Women

2021 ◽  
Vol 12 ◽  
Author(s):  
Jean-Charles Guéry
Keyword(s):  
Dendritic Cells ◽  
Hiv Infection ◽  
X Chromosome ◽  
Type I Interferon ◽  
Acute Infection ◽  
Plasmacytoid Dendritic Cells ◽  
Type I ◽  
Hiv 1 ◽  
Tlr7 Stimulation

Plasmacytoid dendritic cells (pDCs) produce type I interferon (IFN-I) during HIV-1 infection in response to TLR7 stimulation. However, IFN-I-signaling has been shown to play opposite effects in HIV-1 and SIV infection. TLR7-driven type I interferon production in pDCs is higher in women than in men due to the cell-intrinsic actions of estrogen and X-chromosome complement. Indeed, TLR7 is encoded on the X-chromosome, and the TLR7 gene escapes the X-chromosome inactivation in immune cells of women which express significantly higher levels of TLR7 protein than male cells. Following HIV infection, women have a lower viremia during acute infection and exhibit stronger antiviral responses than men, which has been attributed to the increased capacity of female pDCs to produce IFN-α upon TLR7-stimulation. However, a deleterious functional impact of an excessive TLR7 response on acute viremia in women has been recently revealed by the analysis of the frequent rs179008 c.32A&gt;T SNP of TLR7. This SNP was identified as a sex-specific protein abundance quantitative trait locus (pQTL) causing a difference in the TLR7 protein dosage and effector function in females only. T allele expression was associated with a lower TLR7 protein synthesis, blunted production of IFN-α by pDCs upon TLR7 stimulation, and an unexpectedly lower viral load during primary HIV-1 infection in women. In the present review, the author will revisit the role of TLR7-driven pDC innate function in the context of HIV-1 infection to discuss at what stage of primary HIV-1 infection the TLR7 rs179008 T allele is likely to be protective in women.

scholarly journals Prevalence and risk factors for HIV among people aged 50 years and older in Rombo district, Northern Tanzania

2017 ◽  
Vol 19 (2) ◽  
Author(s):  
Scolastica J. Swai ◽  
Damian J. Damian ◽  
Sarah Urassa ◽  
Beatrice Temba ◽  
Michael J. Mahande ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Hiv Prevention ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Hiv Prevalence ◽  
Bivariate Analysis ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Northern Tanzania

Background: It is estimated that over ten percent of the 36.7 million people living with HIV (PLWHIV) globally, are those aged ≥50 years. The objective of this study was to determine the prevalence and risk factors for HIV among adult aged 50 years and above in Rombo district, northern Tanzania.Methods: This cross sectional study was conducted from April to June 2015 among older adults aged ≥50 year in Rombo district. Interviews were conducted to collect information on socio-demographic characteristics, reproductive and sexual health characteristics of the participants, knowledge on HIV transmission, prevention and risk perception and on awareness and knowledge on voluntary and counselling testing services. In addition, a blood sample was taken for HIV diagnosis.Results: A total of 600 people were enrolled. Their age ranged from 50 to 90 years with mean of 64.9 (±SD 10.3) years. The HIV prevalence was 1.7% (n=10) and it was higher among women (2.1%) than men (1.3%). Sixty-percent (n=350) were knowledgeable on HIV transmission and only 40% (n=216) on HIV prevention. In bivariate analysis, age of partner <50 years, ever use of condoms, poor knowledge on HIV prevention and perception of risk on HIV were significantly associated with HIV. However, only partner’s age of <50 years remained significant after controlling for confounders.Conclusion: HIV prevalence and overall knowledge on its transmission among older adults in this rural population were low. There is a need for strategies to improve HIV preventive knowledge and testing in this group in order to continue keeping the transmission at low levels.

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