scholarly journals Clinical and laboratory characterictic of acute HIV-infection in adult residents of Novosibirsk region

2019 ◽  
Vol 11 (2) ◽  
pp. 40-44
Author(s):  
Ya. S. Ulyanova ◽  
N. M. Gashnikova ◽  
V. V. Ivlev ◽  
E. I. Krasnova ◽  
N. I. Khokhlova ◽  
...  
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
High Viral Load ◽  
Acute Hiv Infection ◽  
Novosibirsk Region ◽  
Medical Institutions ◽  
Atypical Cells ◽  
Acute Hiv ◽  
Subtype A ◽  
Hiv 1

Purpose of the study. To study the characteristics of acute HIV infection in adults in the Novosibirsk region in 2017– 2018.Materials and methods. 200 patients with acute HIV infection, residents of the Novosibirsk region, aged 15 to 74 years, hospitalized in 2017–2018, 104 men and 96 women were examined. The diagnosis was verified by detecting antibodies to HIV in ELISA with a negative or doubtful result of the immunoblot, as well as by determining the quantitative content of HIV RNA in the blood by PCR. The hemogram, the content of CD4 + lymphocytes in the blood were determined. In addition, HIV-1 was studied in 71 patients for belonging to a genetic group.Results. Patients of 20–40 years old prevailed – 70.5%. The sexual way was dominant in women (69.0%), injecting psychoactive substances was more often in men (32.2%). Frequent symptoms were fever (99%), exanthema (65.5%), polylimfoadenopathy (54.0%). Less common were diarrhea (36.0%), pharyngotonsillitis (23.0%), aphthous stomatitis (6.5%), hepatomegaly or hepatosplenomegaly (8.5%). Secondary diseases were revealed in 26.5% of patients. Leukopenia was recorded in 63.0%, thrombocytopenia in 62.5%, lymphocytosis and atypical cells of the lymphoid series in 14.0%. All patients had a high “viral load” – from 23,000 to 10,000,000 or more copies / ml, a decrease in the number of CD4 + less than 350 cells – in 38.0%. From among 71 patients, 19.7% had HIV-1 subtype A, and 76.0% had recombinant HIV-1 CRF63_02A. In the latter, “viral load” of more than 10,000,000 copies / ml was more often recorded (67.8% vs. 33.4%, p = 0.004).Conclusion. A significant number of cases of acute HIV infection were reported in the Novosibirsk region in 2017– 2018. Its detection is possible by examination of all febrile patients who apply to medical institutions. Early initiation of antiretroviral therapy with the appointment of well-tolerated regimens contributes to the formation of a high commitment to therapy.

scholarly journals 83The Performance of Quantitative HIV-1 RNA Testing (Viral Load) to Diagnose Acute HIV Infection in the New HIV Laboratory Testing Algorithm

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S5-S5
Author(s):  
Hsiu Wu ◽  
Stephanie Cohen ◽  
Emily Westheimer ◽  
Cindy Gay ◽  
Laura Hall ◽  
...  
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
Laboratory Testing ◽  
Acute Hiv Infection ◽  
Acute Hiv ◽  
Testing Algorithm ◽  
Hiv 1

Diagnosing acute HIV infection: The performance of quantitative HIV-1 RNA testing (viral load) in the 2014 laboratory testing algorithm

2017 ◽  
Vol 93 ◽  
pp. 85-86 ◽  
Author(s):  
Hsiu Wu ◽  
Stephanie E. Cohen ◽  
Emily Westheimer ◽  
Cynthia L. Gay ◽  
Laura Hall ◽  
...  
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
Laboratory Testing ◽  
Acute Hiv Infection ◽  
Acute Hiv ◽  
Testing Algorithm ◽  
Hiv 1

scholarly journals HIV-1 RNA testing of pooled dried blood spots is feasible to diagnose acute HIV infection in resource limited settings

2018 ◽  
Vol 33 (2) ◽  
pp. 50-53
Author(s):  
Wentzel Dowling ◽  
Kirsten Veldsman ◽  
Mary G. Katusiime ◽  
Jean Maritz ◽  
Peter Bock ◽  
...  
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
Dried Blood Spots ◽  
Fourth Generation ◽  
Hiv Viral Load ◽  
Resource Limited Settings ◽  
Acute Hiv Infection ◽  
Resource Limited ◽  
Acute Hiv ◽  
Hiv 1

Objectives:Rapid human immunodeficiency virus (HIV) antibody tests, routinely used for diagnosis in adults and older children in resource-limited settings (RLS), do not detect early HIV infections prior to seroconversion or when antibody levels are still low. Nucleic acid amplification to detect HIV-1 RNA is the most sensitive method for acute HIV infection diagnosis, but is costly. We therefore investigated HIV- 1 RNA testing of pooled dried blood spots (DBS) to diagnose acute HIV infection.Design:Laboratory-based investigation.Methods:DBS were collected from HIV-1 Voluntary Counselling and Testing (HVCT) clients who tested negative on the Advanced QualityTM HIV antibody rapid test. DBS samples from five participants were pooled and tested on the COBAS AmpliPrep/COBAS TaqMan HIV-1 (CAP/CTM) Test v2. Individual DBS were tested when pools tested positive ( 200 RNA copies/ml). Acute infection was confirmed by HIV viral load testing, two fourth-generation HIV serological assays, and Geenius™ HIV 1/2 Assay for antibody band identification.Results:Of 482 participants who were tested, one (0.2%) had acute. HIV infection: Fourth generation serology was low-level positive, the plasma HIV viral load was 15 929 HIV-1 RNA copies/ml, gp160 and gp41 antibody bands were positive and the p31 band was negative, indicating a Fiebig Stage 5 infection.Conclusions: Pooled DBS HIV-1 RNA testing is efficient compared to individual testing for acute HIV infection diagnosis. Early identification of participants with acute HIV infection facilitates immediate initiation of antiretroviral therapy to improve immune recovery and prevent transmission to others.

scholarly journals Decreased Seroreactivity in Individuals Initiating Antiretroviral Therapy during Acute HIV Infection

2019 ◽  
Vol 57 (10) ◽  
Author(s):  
Mark M. Manak ◽  
Linda L. Jagodzinski ◽  
Ashley Shutt ◽  
Jennifer A. Malia ◽  
Mike Leos ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Western Blot ◽  
Research Collaboration ◽  
Virologic Suppression ◽  
Infection Status ◽  
Acute Hiv Infection ◽  
Western Blot Assay ◽  
Acute Hiv ◽  
Hiv 1

ABSTRACTAntiretroviral therapy (ART) during acute HIV infection (AHI) interrupts viral dynamics and may delay the emergence of serological markers targeted by current HIV screening and confirmatory assays, thus creating challenges for correctly classifying HIV infection status. The performance of three HIV antigen/antibody combination (HIV Ag/Ab Combo) assays (the Bio-Rad GS, Abbott Architect, and Bio-Rad BioPlex 2200 assays) was evaluated with samples collected from RV254/South East Asia Research Collaboration in HIV 010 (RV254/SEARCH010) study (Bangkok, Thailand) participants at weeks 12 and 24 following the initiation of ART at Fiebig stage I (FI) (n = 23), FII (n = 39), or FIII/IV (n = 22). Supplemental, confirmatory testing was performed by the Geenius HIV 1/2 and HIV-1 Western blot assays (Bio-Rad). Samples from 30 untreated, HIV-1-infected individuals demonstrated robust HIV Ag/Ab Combo assay reactivity with well-developed HIV-1 Western blotting profiles by 24 weeks after infection. In contrast, 52.2% of samples from individuals initiating ART at FI, 7.7% of samples from individuals initiating ART at FII, and 4.5% of samples from individuals initiating ART at FIII/IV were nonreactive by the HIV Ag/Ab Combo assays, with 36.4 to 39.1% of samples having low signal-to-cutoff (S/CO) results by the Architect and BioPlex assays (S/CO < 10). Seroreversion from a reactive to a nonreactive status was observed in 10 individuals initiating ART at FII and 3 individuals initiating ART at FIII/IV. The Geenius and HIV-1 Western blot assay results were negative or indeterminate for 73.9% and 69.6% of individuals, respectively, treated at FI; 50.0% and 26.3% of individuals, respectively, treated at FII; and 54.5% and 40.9% of individuals, respectively, treated at FIII/IV. Virologic suppression of HIV-1 by ART during AHI impedes seroconversion to biomarkers of infection, limiting the utility of HIV Ag/Ab Combo and supplemental, confirmatory assays for infection status determination.

scholarly journals HIV-1 RNA testing of pooled dried blood spots is feasible to diagnose acute HIV infection in resource limited settings

2017 ◽  
Vol 33 (2) ◽  
pp. 50-53
Author(s):  
Wentzel Dowling ◽  
Kirsten Veldsman ◽  
Mary Grace Katusiime ◽  
Jean Maritz ◽  
Peter Bock ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Dried Blood Spots ◽  
Resource Limited Settings ◽  
Acute Hiv Infection ◽  
Blood Spots ◽  
Resource Limited ◽  
Acute Hiv ◽  
Hiv 1

scholarly journals Acute HIV Infection in Pregnancy: The Case for Third Trimester Rescreening

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Jocelyn Wertz ◽  
Jason Cesario ◽  
Jennifer Sackrison ◽  
Sean Kim ◽  
Chi Dola
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
Late Pregnancy ◽  
First Trimester ◽  
Acute Hiv Infection ◽  
Hiv Rna ◽  
Increased Risk ◽  
Acute Hiv ◽  
Anti Hiv ◽  
In Pregnancy

Combination testing with anti-HIV Elisa and Western blot is both sensitive and specific for diagnosis of established HIV-1 infection but could not detect acute HIV infection (AHI). AHI is a time of extremely high viral load, which may correlate to increased risk of horizontal or vertical transmission. Thus, early identification of AHI could allow for interventions to decrease transmission. However, recognition of AHI can be challenging as symptoms could be absent or nonspecific, therefore, AHI is often not detected, particularly in pregnancy. We present a case report of AHI in a pregnant woman who presented with headache and fever. She tested negative for HIV in the first trimester and at time of AHI at 26 3/7 weeks by anti-HIV Elisa, but was diagnosed with AHI based on an HIV RNA viral load of 434,000 copies/mL. This report presents a case for improved awareness of AHI in pregnancy, and the need for repeat HIV testing in late pregnancy, and highlighted that early detection of AHI might be possible with adding HIV RNA testing at time of standard anti-HIV Elisa screening test in pregnancy. Novel laboratory approaches including pooling of sera for HIV RNA could reduce the cost of HIV RNA testing.

scholarly journals Detection of Acute HIV Infection: A Field Evaluation of the Determine® HIV-1/2 Ag/Ab Combo Test

2011 ◽  
Vol 205 (4) ◽  
pp. 528-534 ◽  
Author(s):  
Nora E. Rosenberg ◽  
Gift Kamanga ◽  
Sam Phiri ◽  
Dominic Nsona ◽  
Audrey Pettifor ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Field Evaluation ◽  
Acute Hiv Infection ◽  
Acute Hiv ◽  
Hiv 1

scholarly journals Understanding of Perceived Infectiousness and Its Influence on Sexual Behavior Among Individuals With Acute HIV Infection in Lilongwe, Malawi (HPTN 062)

2020 ◽  
Vol 32 (3) ◽  
pp. 260-270
Author(s):  
Tiarney D. Ritchwood ◽  
Cecilia Massa ◽  
Gift Kamanga ◽  
Audrey Pettifor ◽  
Irving Hoffman ◽  
...  
Keyword(s):  
Sexual Behavior ◽  
Viral Load ◽  
Mixed Methods ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Unprotected Sex ◽  
Acute Hiv Infection ◽  
Acute Hiv ◽  
Key Aspects ◽  
To Receive

We implemented HPTN 062, an acceptability and feasibility study of a motivational-interviewing (MI) intervention to reduce HIV transmission among individuals with acute HIV infection (AHI) in Lilongwe, Malawi. Participants were randomly assigned to receive either brief education or the MI intervention over 24 weeks; all participants received the same messages about AHI. We used mixed methods to assess participants' understanding of the association between AHI and viral load, and its connection to sexual behavior at 8 weeks. While most participants understood key aspects of AHI, MI-intervention participants gave substantially more detailed descriptions of their understanding. Nearly all participants, regardless of study arm, understood that they were highly infectious and would be very likely to transmit HIV after unprotected sex during AHI. Our findings suggest that messages about AHI delivered during the period of AHI are likely beneficial for ensuring that those with AHI understand their level of infectiousness and its association with forward transmission.

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.

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