Evaluation of the Determine Rapid Syphilis TP Assay Using Sera

ABSTRACT The Abbott Determine Rapid Syphilis TP assay is a treponemal test that can be used in resource-poor settings that lack laboratory facilities. However, this test has not been extensively evaluated. We measured its sensitivity and specificity by using stored serum specimens (n = 567) from all persons who tested Treponema pallidum hemagglutination assay (TPHA) positive (n = 250) or TPHA indeterminate (n = 17) in the year 2001 and the first 300 patients in 2001 who tested TPHA negative at the Evandro Chagas Research Institute in Rio de Janeiro, Brazil. This rapid assay was independently interpreted by three different observers. With TPHA results as the reference, sensitivity ranged between readers from 95.6 to 98.4% and specificity ranged from 97.3 to 95.7%. There was little interreader variability in the interpretation of results, with approximately 98% agreement for all reader combinations. Of samples from persons with human immunodeficiency virus (HIV) infection (n = 198), sensitivity was 96.9 to 99.2% and it was 94.4 to 96.3% among HIV-negative persons (n = 127). Specificity was 92.4 to 95.5% among HIV-positive persons and 97.2 to 100% among HIV-negative persons. We found this test to have high sensitivity and specificity and little interreader variability, indicating that it may be easily used in resource-poor settings without laboratory facilities. Further studies are needed using this test on whole blood and under the clinical conditions for which it is intended.

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Novel Recombinant-Antigen Enzyme Immunoassay for Serological Diagnosis of Syphilis

Journal of Clinical Microbiology ◽

10.1128/jcm.36.4.913-917.1998 ◽

1998 ◽

Vol 36 (4) ◽

pp. 913-917 ◽

Cited By ~ 51

Author(s):

H. Young ◽

A. Moyes ◽

L. Seagar ◽

A. McMillan

Keyword(s):

Enzyme Immunoassay ◽

Treponema Pallidum ◽

High Sensitivity ◽

Hemagglutination Assay ◽

Large Numbers ◽

Immunodeficiency Virus ◽

Treponemal Infection ◽

Serodiagnosis Of Syphilis ◽

Ideal Method ◽

Test Serum

Enzyme immunoassay (EIA) is an ideal method for screening large numbers of patients for syphilis. We evaluated a novel immune-capture EIA (ICE Syphilis; Murex Diagnostics) that uses three recombinantTreponema pallidum antigens (TpN15, TpN17, and TpN47) and compared the results with those obtained by the native T. pallidum antigen EIA (Captia SelectSyph-G; Centocor) that we currently use for the serodiagnosis of syphilis. Specificity was evaluated by screening 1,184 unselected serum specimens in parallel by the ICE Syphilis and SelectSyph-G assays, while sensitivity was tested with a panel of 101 serum specimens containing antitreponemal antibodies (treated and untreated) from patients with various stages of infection. The specificity of the ICE Syphilis EIA (99.8%) on screening was significantly higher (P < 0.02) than that of the SelectSyph-G EIA (99.2%). The sensitivity of the ICE Syphilis EIA was significantly higher (P < 0.01) than that of the SelectSyph-G EIA on both initial (99 versus 91.4%) and repeat (100 versus 92.4%) testing. The ICE Syphilis EIA was also significantly more sensitive (P < 0.01) than the fluorescent treponemal antibody-abs (92.4%) but not the T. pallidum hemagglutination assay (97.1%). Sera containing antitreponemal antibodies gave a much higher antibody index (absorbance of test serum/kit cutoff) by the ICE Syphilis EIA than by the SelectSyph-G EIA. This combined with the overall high sensitivity makes the ICE Syphilis EIA an ideal test for excluding or detecting treponemal infection in human immunodeficiency virus (HIV)-infected patients. The ICE Syphilis EIA was positive with sera from all 15 HIV-infected patients in the study, whereas sera from 3 HIV-infected patients were negative by the SelectSyph-G EIA. We conclude that the high sensitivity and specificity of the ICE Syphilis EIA and its suitability for automation make it an ideal screening test.

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Abstract WP426: Subarachnoid Hemorrhage in patients infected with Human Immunodeficiency Virus

Stroke ◽

10.1161/str.44.suppl_1.awp426 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Haralabos Zacharatos ◽

Malik M Adil ◽

Ameer E Hassan ◽

Sarwat I Gilani ◽

Adnan I Qureshi

Keyword(s):

Human Immunodeficiency Virus ◽

Subarachnoid Hemorrhage ◽

Blood Transfusion ◽

Hospital Mortality ◽

Hiv Infection ◽

The United States ◽

Hiv Positive ◽

Published Data ◽

Immunodeficiency Virus ◽

Hiv Negative

Background: There is limited data regarding the unique attributes of ischemic stroke among patients infected with human immunodeficiency virus (HIV). There is no published data regarding the occurrence and outcomes of subarachnoid hemorrhage (SAH) among HIV infected persons. Methods: The largest all-payer Nationwide Inpatient Sample (NIS 2002-2010) data was used to identify and analyze all patients presenting with the primary diagnosis of SAH in the United States. Among this cohort, we identified the patients who were not HIV positive and those who were HIV positive. Patient demographics, medical co-morbidities, in-hospital complications, in-hospital procedures, and discharge disposition were compared between the two groups. The association between HIV infection and outcomes was evaluated in multivariate analysis after adjusting for potential confounders. Results: Of the 351,491 patients admitted with SAH, 1367 (0.39%) were infected with HIV. HIV infected patients were younger, mean age [±SD] of 45 ±14.2 years versus those who were not 58±19 years, (p<0.0001). The rate of blood transfusion [27,286 (7.8%) versus 245.6 (18%), p=0.0003], mechanical ventilation [51,199 (14.6%) versus 316.1(23.1%), p=0.008], and sepsis [14,644 (4.2%) versus 236.1 (17.3%), p<0.0001] was significantly higher among HIV infected patients. After adjusting for age, gender, hypertension, coagulopathy, atrial fibrillation, renal failure, and dyslipidemia, HIV negative patients had a significantly higher rate of discharge to home (odds ratio [OR] 1.9, 95% CI: 1.4-2.6, p<0.0001) and lower in-patient mortality (OR 0.4, 95% CI: 0.3-0.5, p<0.001). Further adjustment for blood transfusion and sepsis reduced the odds of discharge to home for the HIV negative patients, from 1.9 to 1.7 but did not affect in-hospital mortality. Conclusion: The in-hospital mortality in HIV infected patients with SAH is higher despite these patients being younger than non-HIV infected patients. We believe that this study provides a nationwide perspective which may have some important implications for early recognition and diagnosis of HIV-infection in SAH patients.

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Antimalarial drug resistance markers in human immunodeficiency virus (HIV)-positive and HIV-negative adults with asymptomatic malaria infections in Port Harcourt, Nigeria

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/trab061 ◽

2021 ◽

Author(s):

Ifeyinwa Chijioke-Nwauche ◽

Mary C Oguike ◽

Chijioke A Nwauche ◽

Khalid B Beshir ◽

Colin J Sutherland

Keyword(s):

Human Immunodeficiency Virus ◽

Drug Resistance ◽

Drug Susceptibility ◽

Blood Film ◽

University Hospital ◽

Hiv Positive ◽

Asymptomatic Malaria ◽

Immunodeficiency Virus ◽

Before And After ◽

Hiv Negative

Abstract Background In Nigeria, indiscriminate use of antimalarial drugs may contribute to the threat of drug resistance, but this has not been evaluated among people living with human immunodeficiency virus (HIV). Methods HIV-positive adults attending a university hospital HIV clinic and HIV-negative adult volunteers from the university hospital community with a positive blood film were treated with artemether–lumefantrine. Parasite DNA from before and after treatment was polymerase chain reaction amplified to identify molecular markers of drug susceptibility. Results The pfcrt76T genotype was prevalent among both HIV-positive and HIV-negative participants (78.6% and 68.2%, respectively). Three new mutations in the pfmdr1 gene—F73S, S97L and G165R—and the uncommon pfdhps S436F variant were detected, whereas pfdhps K540E and pfdhfr I164L were absent. The A437G allele of pfdhps predominated (62/66 [94%]). The I431 V mutation was found in 19 of 66 pretreatment pfdhps sequences (28.8%). The pfmdr1 86N allele was significantly more common at day 3 post-treatment than at baseline (odds ratio 8.77 [95% confidence interval 1.21 to 380]). Conclusions We found evidence of continued chloroquine use among HIV-positive individuals. Selection for the pfmdr1 86N after artemether–lumefantrine treatment was observed, indicating a possible threat to antimalarial efficacy in the study area. The complexity of pfdhps haplotypes emphasises the need for careful monitoring of anti-folate susceptibility in Nigeria.

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Evaluation of the Elecsys Syphilis Immunoassay for Detection of Syphilis in Populations at Risk of Disease in the US and Argentina

The Journal of Applied Laboratory Medicine ◽

10.1373/jalm.2017.024943 ◽

2018 ◽

Vol 3 (1) ◽

pp. 89-99 ◽

Cited By ~ 1

Author(s):

Robert H Christenson ◽

Marvin Lessig ◽

Gabrielle Miles ◽

Silke Luebcke ◽

Cheryl Stillions ◽

...

Keyword(s):

At Risk ◽

Sensitivity And Specificity ◽

Treponema Pallidum ◽

High Sensitivity ◽

Primary Objective ◽

Screening Assay ◽

Syphilis Infection ◽

Populations At Risk ◽

The Us ◽

Testing Algorithm

Abstract Background The Elecsys® syphilis immunoassay is an automated, qualitative immunoassay that uses a double-antigen sandwich format to detect antibodies to Treponema pallidum in human serum and plasma. We aimed to validate performance of the immunoassay in various populations at risk for syphilis infection in the US and Argentina. Methods Samples were obtained for a number of study cohorts, including participants from routine syphilis testing at high or low risk for syphilis, HIV-positive patients, pregnant women, and patients in various stages of syphilis infection. The primary objective was to validate the Elecsys syphilis immunoassay by comparing it with a composite testing algorithm using US Food and Drug Administration (FDA)-approved tests, including the predicate IMMULITE 2000 syphilis screening assay, the rapid plasma reagin, and the T. pallidum particle agglutination assay. Results Complete algorithm testing was performed on all 2660 collected samples. Acceptable precision was demonstrated in all samples. Comparison of the Elecsys syphilis immunoassay with the final syphilis status for all samples yielded a diagnostic sensitivity of 99.5% (95% CI, 98.21–99.94) and a diagnostic specificity of 99.2% (95% CI, 98.69–99.49). Overall, the lower limit of the 95% CIs for sensitivity and specificity met the expected performance of ≥95%. Conclusion This is the first study that confirms the high sensitivity and specificity of the Elecsys syphilis immunoassay in US and Argentinian cohorts and highlights the assay's usefulness as an alternative to current tests for the diagnosis of syphilis infection in a broad range of participant cohorts.

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Whole genome sequencing based differentiation between re-infection and relapse in Indian patients with tuberculosis recurrence, with and without HIV co-infection

10.1101/2020.07.29.227926 ◽

2020 ◽

Author(s):

Sivakumar Shanmugam ◽

Nathan L Bachmann ◽

Elena Martinez ◽

Ranjeeta Menon ◽

Gopalan Narendran ◽

...

Keyword(s):

Public Health ◽

Whole Genome Sequencing ◽

Genome Sequencing ◽

Repeat Unit ◽

Hiv Positive ◽

Whole Genome ◽

Immunodeficiency Virus ◽

High Contribution ◽

Tuberculosis Recurrence ◽

Hiv Negative

AbstractDifferentiation between relapse and reinfection in cases with tuberculosis (TB) recurrence has important implications for public health, especially in patients with human immunodeficiency virus (HIV) co-infection. Forty-one paired M. tuberculosis isolates collected from 20 HIV-positive and 21 HIV-negative patients, who experienced TB recurrence after previous successful treatment, were subjected to whole genome sequencing (WGS) in addition to spoligotyping and mycobacterial interspersed repeat unit (MIRU) typing. Comparison of M. tuberculosis genomes indicated that 95% of TB recurrences in the HIV-negative cohort were due to relapse, while the majority of TB recurrences (75%) in the HIV-positive cohort was due to re-infection (P=0.0001). Drug resistance conferring mutations were documented in four pairs (9%) of isolates associated with relapse. The high contribution of re-infection to TB among HIV patients warrants further study to explore risk factors for TB exposure in the community.

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Trypanosoma cruziParasitemia in Chronic Chagas Disease: Comparison between Human Immunodeficiency Virus (HIV)–Positive and HIV‐Negative Patients

The Journal of Infectious Diseases ◽

10.1086/342510 ◽

2002 ◽

Vol 186 (6) ◽

pp. 872-875 ◽

Cited By ~ 70

Author(s):

Ana Marli C. Sartori ◽

José Eluf Neto ◽

Elizabete Visone Nunes ◽

Lucia Maria Almeida Braz ◽

Hélio H. Caiaffa‐Filho ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Chagas Disease ◽

Hiv Positive ◽

Immunodeficiency Virus ◽

Chronic Chagas Disease ◽

Hiv Negative

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Neurocysticercosis and HIV Infection: what can we learn from the published literature?

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20190054 ◽

2019 ◽

Vol 77 (5) ◽

pp. 357-365 ◽

Cited By ~ 4

Author(s):

Omar Herrera Vazquez ◽

Matthew L. Romo ◽

Agnès Fleury

Keyword(s):

Hiv Infection ◽

Immune Status ◽

Taenia Solium ◽

Response To Treatment ◽

Hiv Positive ◽

Historical Series ◽

Immunodeficiency Virus ◽

The Central Nervous System ◽

Published Research ◽

Hiv Negative

ABSTRACT Infections caused by the human immunodeficiency virus (HIV) and by the larvae of Taenia solium (i.e., cysticercosis) are still widespread in many developing countries. Both pathologies modify host immune status and it is possible that HIV infection may modulate the frequency and pathogeny of cysticercosis of the central nervous system (i.e., neurocysticercosis [NCC]). Objective: To describe published cases of NCC among HIV-positive patients and to evaluate whether the characteristics of NCC, including frequency, symptoms, radiological appearance, and response to treatment differed between HIV-positive and HIV-negative patients. Methods: Forty cases of NCC/HIV co-infected patients were identified in the literature. Clinical and radiological characteristics, as well as response to treatment, were compared with non-matching historical series of NCC patients without HIV infection. Results: Most of these patients had seizures and multiple vesicular parasites located in parenchyma. Clinical and radiological characteristics were similar between HIV-positive and HIV-negative patients with NCC, as well as between immunocompromised and non-immunocompromised HIV-positive patients. Conclusion: Our review did not reveal clear interactions between HIV and NCC. This may be partially due to the small number of cases and reliance on published research. A systematic, multi-institutional effort aiming to report all the cases of this dual pathology is needed to confirm this finding and to clarify the possible relationship between both pathogens.

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Human immunodeficiency virus (HIV) Tat-reactive antibodies present in normal HIV-negative sera and depleted in HIV-positive sera. Identification of the epitope.

Journal of Experimental Medicine ◽

10.1084/jem.175.5.1247 ◽

1992 ◽

Vol 175 (5) ◽

pp. 1247-1253 ◽

Cited By ~ 20

Author(s):

T C Rodman ◽

F H Pruslin ◽

S E To ◽

R Winston

Keyword(s):

Human Immunodeficiency Virus ◽

Natural Antibodies ◽

Hiv Positive ◽

Tat Protein ◽

Very High Frequency ◽

Hiv Pathogenesis ◽

Humoral Immune ◽

Igm Antibodies ◽

Immunodeficiency Virus ◽

Hiv Negative

We have detected, in sera of normal human immunodeficiency virus (HIV)-free subjects, IgM antibodies reactive with the Tat protein of HIV in significant titers and at very high frequency, and, in HIV-positive sera, progressively lower titers as HIV pathogenesis ensues. Epitope analysis indicates that the Tat-reactive antibodies of both HIV-negative and HIV-positive sera are homologous, suggesting, therefore, that their decline in HIV-positive sera may represent attrition of a host defense factor. The identified epitope displays minimal homology with that previously defined for another set of IgM antibodies shown to be present in normal sera, deficient in HIV-positive sera, and postulated to be natural antibodies. We propose that the Tat-reactive antibodies, as well, are a set of natural antibodies and that the normal humoral immune system includes a repertoire of antibodies, nonimmunogenic in origin, that contribute to immune homeostasis and, consequently, to host resistance to HIV pathogenesis.

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Intramedullary tuberculoma of the spinal cord

Journal of Neurosurgery Spine ◽

10.3171/spi.1999.90.1.0125 ◽

1999 ◽

Vol 90 (1) ◽

pp. 125-128 ◽

Cited By ~ 12

Author(s):

John K. Ratliff ◽

Edward S. Connolly

Keyword(s):

Spinal Cord ◽

World Literature ◽

Unusual Case ◽

Spinal Tuberculosis ◽

Tuberculosis Infection ◽

Hiv Positive ◽

Content Type ◽

First Case ◽

Immunodeficiency Virus ◽

Hiv Negative

✓ Intramedullary spinal tuberculosis infection remains an extremely rare disease entity. In the most recent reviews only 148 cases have been reported in the world literature, although numerous recent reports from developing countries and on human immunodeficiency virus (HIV)—positive patients have increased this number. The authors present an unusual case of intramedullary tuberculoma in an HIV—negative patient from the southern United States who demonstrated no other signs or symptoms of tuberculosis infection. The authors believe that this is the first case of its kind to be presented in recent literature. The presentation of miliary disease via an isolated intramedullary spinal mass in a patient with no evident risk factors for tuberculosis infection emphasizes the importance of including tuberculosis in the differential diagnosis of spinal cord masses.

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