Seroreversion in Subjects Receiving Antiretroviral Therapy during Acute/Early HIV Infection
Oxford University Press, 2006
academicJournal
Zugriff:
Background . We assessed human immunodeficiency virus (HIV) antibody seroreversion among individuals initiating antiretroviral therapy (ART) during acute/early HIV infection and determined whether seroreversion was associated with loss of cytotoxic T lymphocyte responses. Methods . Subjects in a cohort with acute/early HIV infection (<12 months into infection) who initiated ART within 28 days after study entry and maintained HIV type 1 ribonucleic acid levels of ⩽500 copies/mL for >24 weeks were selected. Two clinically available second-generation enzyme immunoassays (EIAs) and a confirmatory Western blot were used to screen subjects for antibody reversion. Those with negative screening test results underwent additional antibody testing, including a third-generation EIA, and were assessed for cytotoxic T lymphocyte responses. Results . Of 87 subjects identified, 12 (14%) had negative antibody test results at the start of ART; all 12 had seroconversion, although 1 had seroconversion only on a third-generation EIA. Of the 87 subjects, 6 (7%) had seroreversion on at least 1 EIA antibody assay while receiving ART during a median follow-up of 90 weeks. The only clinical predictor of seroreversion was a low baseline “detuned” (less sensitive) antibody. Cytotoxic T lymphocyte responses to HIV Gag peptides were detected in 4 of 5 subjects with seroreversion who could be tested. All 5 who had seroreversion who stopped ART experienced virologic rebound and antibody evolution. Conclusions . HIV antibody seroconversion on second-generation EIA antibody tests may fail to occur when ART is initiated early. Seroreversion was not uncommon among subjects treated early, although cytotoxic T lymphocyte responses to HIV antigens remained detectable in most subjects. Antibody seroreversion did not indicate viral eradication. A third-generation EIA was the most sensitive test for HIV antibodies.
Titel: |
Seroreversion in Subjects Receiving Antiretroviral Therapy during Acute/Early HIV Infection
|
---|---|
Autor/in / Beteiligte Person: | Hare, C. Bradley ; Pappalardo, Brandee L. ; Busch, Michael P. ; Karlsson, Annika C. ; Phelps, Bruce H. ; Alexander, Steven S. ; Bentsen, Christopher ; Ramstead, Clarissa A. ; Nixon, Douglas F. ; Levy, Jay A. ; Hecht, Frederick M. |
Link: | |
Veröffentlichung: | Oxford University Press, 2006 |
Medientyp: | academicJournal |
DOI: | 10.1086/500215 |
Schlagwort: |
|
Sonstiges: |
|