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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Rapid, real-time detection of acute HIV infection in patients in Africa
Journal of Infectious Diseases, Volume 195, No. 3, Year 2007
Notification
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Description
Background. We conducted a prospective study to evaluate methods of detecting clients with sexually transmitted diseases (STDs) who were acutely coinfected with human immunodeficiency virus (HIV) in Lilongwe, Malawi. Methods. After informed consent was obtained, all clients with acute STDs were offered voluntary HIV counseling and testing by 2 rapid antibody tests. Samples from rapid test-negative or -discordant subjects were pooled (50:5:1) and tested for HIV RNA. Western blots were performed on all rapid test-discordant specimens with detectable HIV RNA. A subset of specimens received p24 antigen testing with standard and/or ultrasensitive methods. Patients with possible acute HIV infection were followed to confirm seroconversion. Results. A total of 1450 clients (34% female and 66% male) agreed to testing, of whom 588 (40.55%) had established HIV infection and 21 (1.45%) had acute infection. Discordant rapid antibody tests identified 7 of 21 (33.3% sensitivity), standard p24 antigen identified 12 of 16 (75% sensitivity), and ultrasensitive p24 antigen identified 15 of 17 (88% sensitivity) acute cases. By definition, the sensitivity of the RNA assay was 100%. Conclusions. Real-time pooled RNA testing for the detection of acute HIV infection is feasible in resource-limited settings. However, parallel rapid testing and p24 antigen testing are technologically simpler and together may detect ∼90% of acute cases. © 2006 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Fiscus, Susan A.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Pilcher, Christopher D.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Miller, William C.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Powers, Kimberly A.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Hoffman, Irving F.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Price, Matt A.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
United States, New York
International Aids Vaccine Initiative
Chilongozi, David A.T.
Malawi, Lilongwe
Lilongwe Central Hospital
Mapanje, Clement
Malawi, Lilongwe
Lilongwe Central Hospital
Krysiak, Robert G.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Gama, Syze
Malawi, Lilongwe
Lilongwe Central Hospital
Martinson, Francis E.A.
Malawi, Lilongwe
Lilongwe Central Hospital
Cohen, Myron S.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Makwenda, Wongani
Unknown Affiliation
Joabe, Annie
Unknown Affiliation
Bonongwe, Naomi
Unknown Affiliation
Kanyamula, Happiness
Unknown Affiliation
Malahleka, Mary
Unknown Affiliation
Dzama, Lucy
Unknown Affiliation
Mawindo, Patricia M.
Unknown Affiliation
Milonde, Hellen
Unknown Affiliation
Kumwenda, Phalida
Unknown Affiliation
Makala, Yvonne
Unknown Affiliation
Ndalama, Beatrice
Unknown Affiliation
Kumwenda, Ben
Unknown Affiliation
Mkamanga, Abraham
Unknown Affiliation
Namakhwa, David
Unknown Affiliation
Statistics
Citations: 106
Authors: 26
Affiliations: 3
Identifiers
Doi:
10.1086/510755
ISSN:
00221899
Research Areas
Infectious Diseases
Study Design
Cohort Study
Study Locations
Malawi
Participants Gender
Male
Female