Abstract
BackgroundCross-sectional assessment of HIV incidence relies on laboratory methods to discriminate between recent and non-recent HIV infection. Because HIV diversifies over time in infected individuals, HIV diversity may serve as a biomarker for assessing HIV incidence. We used a high resolution melting (HRM) diversity assay to compare HIV diversity in adults with different stages of HIV infection. This assay provides a single numeric HRM score that reflects the level of genetic diversity of HIV in a sample from an infected individual.MethodsHIV diversity was measured in 203 adults: 20 with acute HIV infection (RNA positive, antibody negative), 116 with recent HIV infection (tested a median of 189 days after a previous negative HIV test, range 14–540 days), and 67 with non-recent HIV infection (HIV infected >2 years). HRM scores were generated for two regions in gag, one region in pol, and three regions in env.ResultsMedian HRM scores were higher in non-recent infection than in recent infection for all six regions tested. In multivariate models, higher HRM scores in three of the six regions were independently associated with non-recent HIV infection.ConclusionsThe HRM diversity assay provides a simple, scalable method for measuring HIV diversity. HRM scores, which reflect the genetic diversity in a viral population, may be useful biomarkers for evaluation of HIV incidence, particularly if multiple regions of the HIV genome are examined.
Highlights
Accurate methods for measuring HIV incidence using crosssectional samples are important for monitoring the HIV epidemic and assessing the efficacy of interventions for HIV prevention [1]
We recently developed a rapid assay for HIV diversity based on high resolution melting (HRM) technology [21]
Cohort (JHHCC), and Johns Hopkins Hospital Emergency Department (JHH ED) studies were conducted according to the ethical standards set forth by the institutional review boards of the participating institutions and the Helsinki Declaration of the World Medical Association; participants provided written, informed consent [24,25,26,27]
Summary
Accurate methods for measuring HIV incidence using crosssectional samples are important for monitoring the HIV epidemic and assessing the efficacy of interventions for HIV prevention [1]. Because HIV generally diversifies over time in infected individuals, HIV diversity may serve as a biomarker for assessing HIV incidence [5]. Most studies of HIV diversity have used sequence-based methods to analyze individual HIV variants in infected individuals [6,7,8] Those studies demonstrate that HIV infection is usually initiated by one or a small number of founder virions [9]. We used a high resolution melting (HRM) diversity assay to compare HIV diversity in adults with different stages of HIV infection This assay provides a single numeric HRM score that reflects the level of genetic diversity of HIV in a sample from an infected individual
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