Abstract
The number, intensity and order of emergence of HIV-1 specific antibodies in serum or plasma were associated with the stage of HIV-1 infection. In this study, we retrospectively analyzed the HIV-1 confirmatory results tested by western blot (WB) or recombination immunoblot assay (RIBA) in Wuhan, 2012–2018, to access the profiles of HIV-1 specific antibodies. A total of 14432 HIV-suspected serum or plasma samples collected from local hospitals and other HIV screening laboratories were further screened by two 4th generation enzyme-linked immunosorbent assay (ELISA) kits in our laboratory, of which 11068 specimens (76.69%) had at least one positive ELISA result and thereby were finally confirmed with WB or RIBA. RIBA had identified 652 (81.09%) positive and 13 (1.62%) indeterminate cases from July 1, 2014 to January 7, 2015, while WB had identified 8358 (81.43%) positive and 643 (6.26%) indeterminate cases in the other times during 2012–2018. The indeterminate rate of WB was significant higher than that of RIBA (p<0.001). Although the number of HIV-1 infected subjects increased significantly from 2012 (n = 911) to 2018 (n = 1578), the positive rate of HIV-1 antibodies decreased markedly from 70.08% in 2012 to 58.79% in 2018 (p<0.001). The most commonly observed antibody profile was gp160+gp120+p66+(p55+)p51+gp41+p31+p24+p17+ (4131, 49.43%) for WB-MP and gp160+gp120+gp41+p31+p24+p17+ (382, 58.59%) for RIBA-WANTAI, and the absence of reactivity to three possible serologic markers for recent HIV-1 infection, p31, p66, and p51, increased significantly from 2012 to 2018, with the overall rate of 17.03%, 9.40%, and 15.15%, respectively. The suspected acute HIV-1 infection was also observed to be increased in recent years, with an overall rate of 1.00%. Our results indicated the detection rate had decreased for HIV-1 infection, but increased for suspected recent and acute HIV-1 infection during 2012–2018, reflecting the efforts of intervention among high risk population.
Highlights
Human immunodeficiency virus (HIV) infection is a major global health concern and social problem [1]
The HIV-1 positive rate was markedly decreased from 70.08% in 2012 to 58.79% in 2018 (p
Previous studies have proven that the sequential emergence of HIV-1 antibodies associates with the progress of HIV-1 infection [11, 12, 24,25,26], the laboratory diagnosis of HIV infection is helpful for understanding the local epidemic and may partly reflect the effectiveness of HIV/AIDS intervention
Summary
Human immunodeficiency virus (HIV) infection is a major global health concern and social problem [1]. More sensitive methods such as nucleic acid test (NAT) were recommended, western blotting (WB) remained to be mostly used as a gold standard method world widely [4] with high sensitivity and specificity for the detection of anti-HIV antibodies [5]. In order to reduce the rate of indeterminate results, line immuno assays (LIA) and recombination immunoblot assay (RIBA) were recruited as a supplemental confirmatory methods for HIV infection [6]. A study conducted in China has proved that RIBA could reduce the window period compared with WB, was recommended as a supplemental assay for confirming HIV infection in China [7]. RIBA has comparable performance to WB [8], it was more popularly used in the diagnosis of hepatitis C virus (HCV), but not HIV, which may due to the reason that HCV is extremely difficult to be tissue culture propagated [9] and can’t be used with natural virus particles for manufacturing WB kit
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