The Impact of Early Antiretroviral Treatment (ART) for HIV on the Sensitivity of the Latest Generation of Blood Screening and Point of Care Assays
Introduction: Rapid initiation of antiretroviral therapy (ART) in early HIV infection is important to limit seeding of the viral reservoir. A number of studies have shown that if ART is commenced prior to seroconversion, the seroconversion may, or may not, occur. We aimed to assess whether serorever...
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MDPI AG
2022-06-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/14/7/1426 |
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| author | Marion Vermeulen Cari van Schalkwyk Genevieve Jacobs Karin van den Berg Mars Stone Sonia Bakkour Brian Custer Ute Jentsch Michael P. Busch Edward Murphy Eduard Grebe |
| author_facet | Marion Vermeulen Cari van Schalkwyk Genevieve Jacobs Karin van den Berg Mars Stone Sonia Bakkour Brian Custer Ute Jentsch Michael P. Busch Edward Murphy Eduard Grebe |
| author_sort | Marion Vermeulen |
| collection | DOAJ |
| description | Introduction: Rapid initiation of antiretroviral therapy (ART) in early HIV infection is important to limit seeding of the viral reservoir. A number of studies have shown that if ART is commenced prior to seroconversion, the seroconversion may, or may not, occur. We aimed to assess whether seroreversion or no seroconversion occurs using samples collected during an early treatment study in South Africa. Methods: We tested 10 longitudinal samples collected over three years from 70 blood donors who initiated ART after detection of acute or early HIV infection during donation screening on fourth- and fifth-generation HIV antibody and RNA assays, and three point of care (POC) rapid tests. Donors were allocated to three treatment groups: (1) very early, (2) early, and (3) later. Longitudinal samples were grouped into time bins post-treatment initiation. Results: On all three high-throughput HIV antibody assays, no clear pattern of declining signal intensity was observed over time after ART initiation in any of the treatment initiation groups and 100% detection was obtained. The Abbott Determine POC assay showed 100% detection at all time points with no seroreversion. However, the Abbott ABON HIV1 and OraSure OraQuick POC assays showed lower proportions of detection in all time bins in the very early treated group, ranging from 50.0% (95% CI: 26.8–73.2%) to 83.1% (95% CI: 64.2–93.0%), and moderate detection rates in the early and later-treated groups. Conclusion: While our findings are generally reassuring for HIV detection when high-throughput serological screening assays are used, POC assays may have lower sensitivity for detection of HIV infection after early treatment. Findings are relevant for blood safety and other settings where POC assays are used. |
| first_indexed | 2024-03-09T10:10:12Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-09T10:10:12Z |
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| series | Viruses |
| spelling | doaj.art-2dbe07e7a9964911b58da3d5ccb600ed2023-12-01T22:46:58ZengMDPI AGViruses1999-49152022-06-01147142610.3390/v14071426The Impact of Early Antiretroviral Treatment (ART) for HIV on the Sensitivity of the Latest Generation of Blood Screening and Point of Care AssaysMarion Vermeulen0Cari van Schalkwyk1Genevieve Jacobs2Karin van den Berg3Mars Stone4Sonia Bakkour5Brian Custer6Ute Jentsch7Michael P. Busch8Edward Murphy9Eduard Grebe10South African National Blood Service, Johannesburg 1715, South AfricaNational Research Foundation Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), The South African Department of Science and Innovation, Stellenbosch University, Stellenbosch 7602, South AfricaSouth African National Blood Service, Johannesburg 1715, South AfricaSouth African National Blood Service, Johannesburg 1715, South AfricaVitalant Research Institute, San Francisco, CA 94118, USAVitalant Research Institute, San Francisco, CA 94118, USAVitalant Research Institute, San Francisco, CA 94118, USASouth African National Blood Service, Johannesburg 1715, South AfricaVitalant Research Institute, San Francisco, CA 94118, USAVitalant Research Institute, San Francisco, CA 94118, USANational Research Foundation Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), The South African Department of Science and Innovation, Stellenbosch University, Stellenbosch 7602, South AfricaIntroduction: Rapid initiation of antiretroviral therapy (ART) in early HIV infection is important to limit seeding of the viral reservoir. A number of studies have shown that if ART is commenced prior to seroconversion, the seroconversion may, or may not, occur. We aimed to assess whether seroreversion or no seroconversion occurs using samples collected during an early treatment study in South Africa. Methods: We tested 10 longitudinal samples collected over three years from 70 blood donors who initiated ART after detection of acute or early HIV infection during donation screening on fourth- and fifth-generation HIV antibody and RNA assays, and three point of care (POC) rapid tests. Donors were allocated to three treatment groups: (1) very early, (2) early, and (3) later. Longitudinal samples were grouped into time bins post-treatment initiation. Results: On all three high-throughput HIV antibody assays, no clear pattern of declining signal intensity was observed over time after ART initiation in any of the treatment initiation groups and 100% detection was obtained. The Abbott Determine POC assay showed 100% detection at all time points with no seroreversion. However, the Abbott ABON HIV1 and OraSure OraQuick POC assays showed lower proportions of detection in all time bins in the very early treated group, ranging from 50.0% (95% CI: 26.8–73.2%) to 83.1% (95% CI: 64.2–93.0%), and moderate detection rates in the early and later-treated groups. Conclusion: While our findings are generally reassuring for HIV detection when high-throughput serological screening assays are used, POC assays may have lower sensitivity for detection of HIV infection after early treatment. Findings are relevant for blood safety and other settings where POC assays are used.https://www.mdpi.com/1999-4915/14/7/1426antiretroviral therapyHIVpoint of care testingserological screening |
| spellingShingle | Marion Vermeulen Cari van Schalkwyk Genevieve Jacobs Karin van den Berg Mars Stone Sonia Bakkour Brian Custer Ute Jentsch Michael P. Busch Edward Murphy Eduard Grebe The Impact of Early Antiretroviral Treatment (ART) for HIV on the Sensitivity of the Latest Generation of Blood Screening and Point of Care Assays Viruses antiretroviral therapy HIV point of care testing serological screening |
| title | The Impact of Early Antiretroviral Treatment (ART) for HIV on the Sensitivity of the Latest Generation of Blood Screening and Point of Care Assays |
| title_full | The Impact of Early Antiretroviral Treatment (ART) for HIV on the Sensitivity of the Latest Generation of Blood Screening and Point of Care Assays |
| title_fullStr | The Impact of Early Antiretroviral Treatment (ART) for HIV on the Sensitivity of the Latest Generation of Blood Screening and Point of Care Assays |
| title_full_unstemmed | The Impact of Early Antiretroviral Treatment (ART) for HIV on the Sensitivity of the Latest Generation of Blood Screening and Point of Care Assays |
| title_short | The Impact of Early Antiretroviral Treatment (ART) for HIV on the Sensitivity of the Latest Generation of Blood Screening and Point of Care Assays |
| title_sort | impact of early antiretroviral treatment art for hiv on the sensitivity of the latest generation of blood screening and point of care assays |
| topic | antiretroviral therapy HIV point of care testing serological screening |
| url | https://www.mdpi.com/1999-4915/14/7/1426 |
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