anti-HIV Antibodies Research Articles

1284 Epstein Barr Virus (EBV)-Associated Acute Pancreatitis: Case Report

INTRODUCTION: EBV infection is mostly subclinical and resolves spontaneously without complications. GI involvement manifests mainly with asymptomatic liver enzyme elevation. We report a case of acute pancreatitis complicating EBV infection. CASE DESCRIPTION/METHODS: An 18-year-old woman presented with 12 day history of moderate unremitting upper abdominal pain, nausea, and anorexia. She had a temperature of 36.8°C, bilateral non-tender cervical lymphadenopathy, mild pharyngeal injection, and moderate epigastric tenderness, but no splenomegaly or jaundice. She didn't take any medications and denied alcohol/illicit drug use. Leukocyte count was 14.5 cells/μL (15% neutrophils, 9% monocytes, 44% reactive lymphocytes), hemoglobin 12.7 g/dL, amylase 327 IU/L, lipase 2016 U/L, alkaline phosphatase 246 IU/L, aspartate aminotransferase 210 IU/L, alanine aminotransferase 283 IU/L, total/direct bilirubin 2/1.6 mg/dL. Calcium, blood glucose, and triglycerides were normal. Ultrasound showed mildly enlarged liver with coarse echotexture, contracted gallbladder, normal common bile duct, and mildly enlarged right upper quadrant lymph nodes, but no intrahepatic biliary ductal dilation. Computed tomography showed acute pancreatitis and mild splenomegaly. Anti-HAV IgM; HBsAg and anti-HBV core IgM; anti-HCV; HIV1 p24 antigen; anti-HIV1 and anti-HIV2 antibodies (AB); and CMV (quantitative PCR) were negative. EBV heterophile AB was positive, EBV IgG viral capsid AB 78.6 U/mL, EBV IgM viral capsid AB >160 U/mL, and EBV IgG early disease AB 70 U/mL. She was treated conservatively and discharged on the fourth day of hospitalization. DISCUSSION: Clinical pancreatitis is rarely associated with EBV infection; only 17 cases have been previously reported. As in our case, most patients were adolescent/young adults, have clear EBV infection picture, and have mild to moderate pancreatitis course with spontaneous recovery. Although acyclovir was tried, it isn't clear if it's required. Our patient was unique in that her hospital stay was 4 days in comparison to a mean of 10 days in other reported cases. EBV infection should be considered in the differential diagnosis of mild to moderate pancreatitis. It is not clear if subclinical pancreatitis in the setting of EBV infection is more common and why only few patients develop clinical pancreatitis.

Brief Report: Decreased JC Virus-Specific Antibody-Dependent Cellular Cytotoxicity in HIV-Seropositive PML Survivors.

Progressive multifocal leukoencephalopathy (PML) is an often fatal disease caused by JC virus (JCV) in severely immunocompromised patients, including HIV patients. Development of therapeutics to prevent or treat PML is an urgent medical need. While JCV-specific T cells are crucial to control JCV and recover from PML, the role played by antibodies remains unclear. Anti-JCV antibodies, including potent neutralizing antibodies, can be detected in most infected adults, yet in PML patients, JCV seems to escape from neutralization. Whether antibodies can contribute to JCV control by eliciting Fc-mediated effector functions activity has not been evaluated. We measured the capacity of plasma anti-JCV VP1 antibodies to recruit Fc receptor (FcR)-bearing effector cell functions in 28 HIV patients, comparing subjects without PML with PML survivors (PML S) who were alive 1 year after disease onset or PML progressors (PML P) who succumbed within the first year. Antibody titers against JCV VP1 and HIV gp140 trimer were determined by end-point titer dilution ELISA. FcR-mediated natural killer cell degranulation and IFN-γ production were measured as surrogate for in vitro antibody-dependent cellular cytotoxicity (ADCC). PML S had higher JCV antibody titers than PML P and patients without PML. However, anti-JCV antibodies had a higher ability to functionally engage FcR in PML P than PML S. Antibody titers and ADCC activity did not vary over time in PML S. Anti-HIV antibody titers and ADCC activity were similar among groups. The ability of anti-JCV antibodies to stimulate FcR-bearing effector cell activity might contribute to the outcome of PML. Further studies are warranted to define Fc-mediated functions of anti-JCV antibodies and evaluate whether ADCC can contain JCV replication.

Rapid development of HIV elite control in a patient with acute infection

BackgroundElite controllers (EC), a small subset of the HIV-positive population (< 1%), suppress HIV viremia below the limit of quantification of clinical viral load assays in the absence of antiretroviral therapy (ART). However, there is a paucity of longitudinal data detailing the viral and immune dynamics or HIV reservoir seeding during acute infection in individuals that go on to become Elite Controllers.Case presentationIn this report, we describe a case of a 42 year old woman diagnosed during acute infection who rapidly and permanently suppressed her viremia in the absence of antiretroviral therapy (ART). Rapid antibody/antigen testing was either negative or equivocal during acute infection, despite subsequent viral load testing at that time point with 71,550 plasma HIV RNA copies/mL, making initial diagnosis challenging. The patient subsequently developed detectable anti-HIV antibodies and an increase in HIV-specific CD8+ T cell responses to overlapping subtype C HIV gag peptide; very low-level plasma viremia (0.84 RNA copies/mL) was detected by an ultrasensitive assay 2 years following infection. Subsequently, she was started on ART for multifocal furunculosis despite continued suppression of virus and stable CD4+ T cell counts. Following ART initiation, CD8+ T cell responses increased, but no HIV DNA or RNA was able to be isolated from large numbers of peripheral blood CD4+ T cells.ConclusionThis case provides important information regarding the establishment of elite HIV control during acute infection and also demonstrates an increase in HIV-specific immune responses following ART despite undetectable peripheral blood cellular measures of HIV persistence. This case also highlights the challenges in diagnosing acute HIV infection without the use of viral load testing in this rare elite controller phenotype.

Boosting of Markers of Fcγ Receptor Function in Anti-HIV Antibodies During Structured Treatment Interruption.

Anti-HIV envelope (Env) antibodies elicit important Fc receptor functions, including FcγRIIIa-mediated natural killer cell killing of opsonized infected targets. How these antibodies evolve during HIV infection and treatment remains poorly understood. We describe changes in anti-HIV Env IgG using longitudinal samples from seroconverter subjects treated soon after infection and later during periods of structured treatment interruption (STI). Our well-validated dimeric rsFcγR binding assays combine effects of opsonizing antibody subclasses, epitopes, and geometries to provide a measure of FcγR (Fcγ receptor)-mediated functionality. IgG1 anti-Env titers diminished rapidly during antiretroviral therapy (ART; t1/2 3.0 ± 0.8 months), while the dimeric rsFcγRIIIa activity persisted longer (t1/2 33 ± 11 months), suggesting that there is maintenance of functional antibody specificities within the diminished pool of anti-HIV Env Abs. The initial antibody response to infection in two subjects was characterized by approximately fivefold higher FcγRIIIa compared with FcγRIIa binding activity. Uncoupling of FcγRIIa and FcγRIIIa activities may be a distinct feature of the early antibody response that preferentially engages FcγRIIIa-mediated effector functions. Two to three STI cycles, even with low viremia, were sufficient to boost dimeric FcγR activity in these seroconverter subjects. We hypothesize that increased humoral immunity induced by STI is a desirable functional outcome potentially achievable by therapeutic immunization during ART. We conclude that controlled viral antigen exposure under the protection of suppressive ART may be effective in eliciting FcγR-dependent function in support of viral reactivation and kill strategies.

The influence of biotinylation on the ability of a computer designed protein to detect B-cells producing anti-HIV-1 2F5 antibodies

Antibodies against the HIV-1 2F5 epitope are known as one of the most powerful and broadly protective anti-HIV antibodies. Therefore, vaccine strategies that include the 2F5 epitope in their formulation require a robust method to detect specific anti-2F5 antibody production by B cells. Towards this goal, we have biotinylated a previously reported computer-designed protein carrying the HIV-1 2F5 epitope aiming the further development of a platform to detect human B-cells expressing anti-2F5 antibodies through flow cytometry. Biophysical and immunological properties of our devised protein were characterized by computer simulation and experimental methods. Biotinylation did not affect folding and improved protein stability and solubility. The biotinylated protein exhibited similar binding affinity trends compared to its unbiotinylated counterpart and was recognized by anti-HIV-1 2F5 antibodies expressed on the surface of patient-derived peripheral blood mononuclear cells. Moreover, we present a high affinity marker for the identification of epitope-specific B cells that can be used to measure the efficacy of vaccine strategies based on the HIV-1 envelope protein.

Framework Mutations of the 10-1074 bnAb Increase Conformational Stability, Manufacturability, and Stability While Preserving Full Neutralization Activity

The broadly neutralizing anti-HIV antibody, 10-1074, is a highly somatically hypermutated IgG1 being developed for prophylaxis in sub-Saharan Africa. A series of algorithms were applied to identify potentially destabilizing residues in the framework of the Fv region. Of 17 residues defined, a variant was identified encompassing 1 light and 3 heavy chain residues, with significantly increased conformational stability while maintaining full neutralization activity. Central to the stabilization was the replacement of the heavy chain residue T108 with R108 at the base of the CDR3 loop which allowed for the formation of a nascent salt bridge with heavy chain residue D137. Three additional mutations were necessary to confer increased conformational stability as evidenced by differential scanning fluorimetry and isothermal chemical unfolding. In addition, we observed increased stability during low pH incubation in which 40% of the parental monomer aggregated while the combinatorial variant showed no increase in aggregation. Incubation of the variant at 100 mg/mL for 6 weeks at 40°C showed a 9-fold decrease in subvisible particles ≥2 μm relative to the parental molecule. Stability-based designs have also translated to improved pharmacokinetics. Together, these data show that increasing conformational stability of the Fab can have profound effects on the manufacturability and long-term stability of a monoclonal antibody.

Targeting broadly neutralizing antibody precursors: a naïve approach to vaccine design.

It is believed that broadly neutralizing antibodies (bNAbs) will be an important component of an effective HIV-1 vaccine. Several immunogens have been designed that can target specific precursor B cells as a first step in a vaccine strategy to elicit bNAbs. Germline-targeting immunogens have been developed that specifically engage precursors of reproducible classes of anti-HIV antibodies, such as VRC01-class and apex-directed bNAbs. However, these precursors represent only a small portion of the immune repertoire and any antigen will inherently present off-target epitopes to the immune system that may confound bNAb development. Novel animal models are being utilized to understand the competitive fitness of bNAb precursors in the context of immunization with germline-targeting immunogens. In parallel, immunogen design efforts are being pursued to favor the development of bNAb responses over off-target responses following immunization. New studies of bNAb precursor interactions with glycosylated Env variants can inform prime-boost regimens geared towards accelerating bNAb development. Germline-targeting immunogens hold promise as a first step in eliciting a bNAb response through vaccination. A better understating of how efficiently germline-targeting immunogens can specifically target rare bNAb precursors is emerging. In addition, a more comprehensive structure-based understanding of critical barriers to bNAb elicitation, as well as commonalities between bNAb classes can further inform vaccine design.

A role for antibodies in natural HIV control.

Rare patients naturally control HIV replication without antiretroviral therapy. Understanding the mechanisms implicated in natural HIV control will inform the development of immunotherapies against HIV. Elite controllers are known for developing efficient antiviral T-cell responses, but recent findings suggest that antibody responses also play a significant role in HIV control. We review the key studies that uncovered a potent memory B-cell response and highly functional anti-HIV antibodies in elite controllers, and explore the mechanisms that may account for the distinct properties of their humoral response. Elite controllers maintain a large HIV-specific memory B-cell pool that is sustained by efficient T follicular helper function. Neutralizing antibody rarely show high titers in controllers, but seem capable, at least in certain cases, of neutralizing contemporaneous viral strains. In addition, elite controllers display a unique HIV-specific antibody profile in terms of isotype, antigen specificity, and glycosylation pattern, resulting in polyfunctional antibody effector functions that may promote infected cell lysis and prime effectors of the antiviral immune response. Lessons from elite controller studies argue for the importance of integrating the many parameters defining a polyfunctional antibody response when evaluating candidate vaccines and immunotherapeutic approaches directed at HIV.

Quantifying Anti-HIV Envelope-Specific Antibodies in Plasma from HIV Infected Individuals.

Quantifying HIV Envelope (Env)-specific antibodies in HIV+ plasma is useful for interpreting antibody dependent cellular cytotoxicity assay results. HIV Env, the only viral protein expressed on the surface of infected cells, has a native trimeric closed conformation on cells infected with wild-type HIV. However, CD4+ uninfected bystander cells in HIV+ cell cultures bind gp120 shed from HIV+ cells exposing CD4-induced epitopes normally hidden in native Env. We used flow-cytometry based assays to quantify antibodies in HIV+ plasma specific for native trimeric Env or gp120/CD4 conjugates using CEM.NKr.CCR5 (CEM) cells infected with HIV (iCEM) or coated with recombinant gp120 (cCEM), as a surrogate for gp120+ HIV- bystander cells. Results from both assays were compared to those of a plate-based ELISA to monomeric gp120. The levels of Env-specific antibodies to cCEM and iCEM, measured by flow cytometry, and to gp120 by ELISA were positively correlated. More antibodies in HIV+ plasma recognized the gp120 conformation exposed on cCEM than on iCEM. Comparisons of plasma from untreated progressors, treated progressors, and elite controllers revealed that antibodies to Env epitopes were the lowest in treated progressors. Plasma from elite controllers and untreated progressors had similarly high levels of Env-specific antibodies, despite elite controllers having undetectable HIV viral loads, while untreated progressors maintained high viral loads.

The prevalence of HBV, HCV, and HIV infections in patients with cataract in Turkey

Background: Hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) cause common infections all around the world. The aim of this study is to determine the HBV, HCV, and HIV prevalence in cataract patients. Material and methods: This was a retrospective study and was carried out in the ophthalmology clinic of Adana Numune Research and Training Hospital (Adana, Turkey). One hundred and forty patients undergoing cataract surgery were included to the study. The clinical findings were extracted from the medical records of the patients. The serological analyzing was done by one step immunoassay-based rapid diagnostic card tests for hepatitis B surface antigen (HBsAg), anti-HCV, and anti-HIV antibodies. HBV and HCV confirmations were done by ELISA (enzyme-linked immunosorbent assay test)-based serological tests. Results: Of the 1040 patients included in the study, 462 (44.4%) were females and 578 (55.6%) were males. The mean age of the patients was 64.8 ± 13.7 years. HBsAg was positive in 39 (3.8%) patients and Anti-HCV was positive in 14 (1.3%) patients. None of the patients had HIV. Conclusion: HBV is the most common infection among cataract patients and it is very important to apply infection prevention methods.

Seroprevalence of HBV, HCV, and HIV and Associated Risk Factors Among Apparently Healthy Pregnant Women in Anyigba, Nigeria.

Globally, infection of pregnant women by human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) pose a significant health challenge for not just the mothers but also the newborn infant. This study was undertaken to assess the prevalence of HIV, HCV, and HBV among pregnant women attending antenatal clinic in Kogi State University Teaching Hospital (KSUTH), Anyigba, Nigeria. Sera samples obtained from 200 consented pregnant women were screened for hepatitis B surface antigen (HBsAg), anti-HCV, and anti-HIV antibodies using commercially available immunoassay test kit. Demographic variables and obstetric characteristic were obtained using structured questionnaire. Of the 200 sera tested, the seroprevalence rates were 1.0%, 0.5%, and 8.5% for HBsAg, anti-HCV, and anti-HIV antibodies, respectively. Although 0.5% were coinfected with HIV/HCV, none was simultaneously infected by the three viruses. Age, marital status, trimester, and educational and occupational status did not significantly affect the prevalence of HIV, HCV, and HBV infections. However, factors such as history of abortion/miscarriage (p = 0.04), intravenous drug use (p = 0.001), and history of other sexually transmitted infection (p = 0.01) were significantly higher in relation to HIV seropositivity. In conclusion, findings from this study revealed high HIV seroprevalence and a clear decline of hepatitis C and B infection prevalence compared with previous epidemiological data. Reason for the latter could be attributed to the current efforts to reduce mother-to-child transmission and possible HBV vaccination programs. High burden of HIV infection in our study suggests the needs to strengthen the national prevention programs including education of the people on the risk factors of HIV transmission.

Hepatitis B virus, hepatitis C virus and human immunodeficiency virus infections among people who inject drugs in Kuwait: A cross-sectional study

Injection drug use (IDU) is one of the most significant risk factors for viral hepatitis (B and C) and human immunodeficiency virus (HIV) infections. This study assessed seroprevalence rates of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in people who inject drugs (PWID) in Kuwait. We conducted a cross-sectional study from April to September 2017. A total of 521 consecutive subjects, admitted at Al-Sabah Hospital. The serological and virological markers of HBV, HCV, and HIV were tested using automated platforms. The mean age of the participants was 32.26 yrs, and the sex ratio (Male/Female) was 15.28. The prevalence rates of HBsAg, anti-HCV, and anti-HIV antibodies were 0.38% (95% CI: 0.07–1.53%), 12.28% (95% CI: 9.65–15.48), and 0.77% (95% CI: 0.25–2.23%), respectively. HCV-RNA was evident in 51.72% (95% CI: 38.34–64.87%) among anti-HCV positive participants. Multivariate analysis showed that the high prevalence of HCV infection amongst PWID is associated with age. Whereas, multivariate analysis revealed no significant associations with age and gender regarding HIV and HBV infections. The results suggest that high rates of HBV, HCV, and HIV infections among injecting drug users than the general population. These findings emphasize the importance of introducing interventions and harm reduction initiatives that have a high impact on reducing needle sharing.

Use of Monoclonal Antibodies to Prevent the Sexual Transmission of Human Immunodeficiency Virus Type 1

&lt;P&amp;gt;Passive immunization has been used since the late 1800’s to prevent and treat human infectious diseases. Administration of animal immune sera and human immunoglobulin has given way to the use of monoclonal antibodies (mAbs) for passive immunization, and highly potent broadly neutralizing anti-HIV antibodies (bNAbs) are now being considered for HIV therapy and prophylaxis. Recent studies have shown that systemic and topical administration of bNAbs can effectively inhibit HIV/SHIV mucosal transmission in macaques and in humanized mice, and selected bNAbs are currently being tested in clinical trials for safety and efficacy in humans. In this review, we outline strategies for the selection, engineering and manufacture of human bNAbs to prevent the sexual transmission of HIV, describe the proof-of-concept animal studies that have demonstrated mAb-mediated protection against mucosal HIV transmission, and review clinical trials currently underway to test the safety and efficacy of mAb-based HIV prevention in humans.

Adeno-Associated Virus Delivery of Anti-HIV Monoclonal Antibodies Can Drive Long-Term Virologic Suppression

Long-term delivery of anti-HIV monoclonal antibodies (mAbs) using adeno-associated virus (AAV) vectors holds promise for the prevention and treatment of HIV infection. We describe a therapy trial in which four rhesus monkeys were infected with SHIV-AD8 for 86weeks before receiving the AAV-encoded mAbs 3BNC117, 10-1074, and 10E8. Although anti-drug antibody (ADA) responses restricted mAb delivery, one monkey successfully maintained 50-150μg/mL of 3BNC117 and 10-1074 for over 2 years. Delivery of these two mAbs to this monkey resulted in an abrupt decline in plasma viremia, which remained undetectable for 38 successive measurements over 3 years. We generated two more examples of virologic suppression using AAV delivery of a cocktail of four mAbs in a 12-monkey study. Our results provide proof of concept for AAV-delivered mAbs to produce a "functional cure." However, they also serve as a warning that ADAs may be a problem for practical application of this approach in humans.

Characterization of HIV-1 genotype specific antigens for the detection of recent and long-term HIV-1 infection in China

To characterize HIV-1 gp41 as an antigen for developing HIV-1 incidence assay and to investigate the impact of HIV-1 genetic diversity on the assay performance, a number of truncated peptides were synthesized to identify the immunodominant epitopes (IDEs) of HIV-1 gp41 protein. Subsequently, the mixed peptides (MP3) or the recombinant protein (MP4) containing HIV-1 gp41 IDEs of the major HIV-1 genotype CRF01_AE, CRF07_BC/ CRF08_BC and subtype B in China were used to verify the sensitivity and specificity of HIV-1 recency testing. We identified the QKFLG and GKIIC motifs located in the loop region of HIV-1 gp41 as the two major IDEs. The surrounding amino acids EAQQHLLQLT and WNSSWSN could block the binding of gp41 peptide and anti-HIV antibody with low avidity, making the gp41 peptide p57 suitable for distinguishing recent and long-term HIV-1 infections. Furthermore, MP3 or MP4-based immunoassay could significantly improve the assay sensitivity and showed 93.33% (140/150) vs. 94.59% (35/37) and 94.08% (143/152) vs. 94.59% (35/37) concordance with commercially available LAg-Avidity EIA test among the cross-sectional and longitudinal samples, respectively. The estimated mean duration of recent infection (MDRI) was 130 days (95% CI: 83–167) and 166 days (95% CI: 123–202) for MP3 and MP4 assays, respectively. Our preliminary results indicate that the HIV-1 gp41 peptide-based immunoassay specifically targeting the major HIV-1 genotype CRF01_AE, CRF07_BC/CRF08_BC and subtype B could serve as a simple incidence assay for differentiating recent and long-term HIV-1 infections in China.

Towards an HIV Vaccine Based on Immune Network Theory II

We have designed immunization protocols based on the co-section model to induce a broadening antigen antibody response against HIV1. As antigen were various antigen-antibody complexes used, including the monoclonal antibody 1F7 that is expressed on anti-HIV1 antibodies with different antigen specificities. Rabbits were used to test this concept using. Antibodies that neutralized HIV-1 of the same strain as that of the gp120 used were detected, but they did not include broadly neutralizing antibodies (BnAbs). Immunization with gp120 in adjuvant induced antibodies binding to gp120, gp41, Nef and p24, a finding predicted by the immune network theory. Furthermore a complex of 1F7 and B12 induced antibodies against gp120 and gp41, demonstrating an antigen broadening response towards achieving the goal of inducing BnAbs through immunization.

Ispitivanje markera krvlju prenosivih bolesti, algoritama testiranja i preventivnih mera

Introduction/Aim The most common blood borne diseases or transfusion transmitted infections (TTI) are hepatitis B, hepatitis C and human immunodeficiency virus (HIV). Numerous tests are used to prove the presence of these viruses indirectly (by detecting antibody presence - ELISA and CLIA) or directly (by detecting the presence of viral genome - NAT-PCR and LCR).To present a two-year analysis of testing for blood borne disease markers in pregnant women, patients preparing for surgery procedures and people with high-risk behavior (HBs Ag, anti-HCV and anti-HIV) at the Belgrade City Institute for Public Health and adopting measures for their prevention. Methodology During the two-year period, 11,983 pregnant women and 934 people with high-risk behavior were tested. Preliminary testing for HBs antigen, anti-HCV antibodies and anti-HIV antibodies was performed with 3rd generation ELISA tests ("Hepanostika HBsAg Uni-Form II", "Vironostika HIV Uni-Form II Ag / Ab" ; "The bioMérieux Clinical Diagnostics," manufactured in France; "Hepanostika HCV Ultra" is manufactured by "Beijing United Biomedical Co.Ltd.", China and the other two are manufactured in France). Primarily positive blood samples were tested again with the same test (in a duplicate procedure) on a new sample which was placed in a "dry" tube with no anticoagulant 10-14 days after being primarily positive for TTI markers. Those samples were also tested with a WB "Western Blot" confirmatory test - WB ("INNO-LIA HCV Ab III"; INNO-LIPA HBV Genotyping "and" INNO-LIA HIV I / II"). "Innogenetics NV ", Belgium is the manufacturer of all three confirmatory tests. Blood samples with positive results on the confirmatory tests for TTI were accepted as positive for HBs Ag, anti-HCV or anti-HIV. Results From 11,983 tested pregnant women, 152 (1.27%) were preliminarily reactive to HBsAg, 38 (0.32%) were confirmed positive for HBsAg and 114 (0.95%) were false reactive to HBsAg; 123 (1.03%) were preliminarily reactive to anti-HCV, 35 (0.29%) pregnant women were confirmed positive for antiHCV and 88 (0.74%) were false reactive for anti-HCV; and 15 (0.13%) pregnant women were preliminarily reactive to anti-HIV, 5 (0.04%) pregnant women were confirmed positive for anti-HIV and 10 (0.09%) were false reactive to anti-HIV. From 934 tested individuals with high-risk behavior 36 (3.85%) were preliminarily reactive to HBs Ag, 28 (2.99%) were confirmed positive for HBsAg and 8 (0.86%) were false reactive to HBsAg; 38 (4.07 %) were preliminarily reactive to anti-HCV, 33 (3.53%) were confirmed positive for anti-HCV and 5 (0.54%) false reactive to anti-HCV and 10 (1.07%) were preliminarily reactive to anti-HIV, 9 (0.96%) were confirmed anti-HIV positive and 1(0.11%) was false reactive to anti-HIV. Conclusion The results of our study showed a higher prevalence of HBsAg, anti-HCV and anti-HIV in people with high-risk behavior than in pregnant women. There are more false reactive results in pregnant women than in people with high-risk behavior. Preventive measures would include broader education on ways blood borne diseases are transmitted, testing blood and blood products with the latest generation of tests and correct execution of medical interventions with special attention on principles of asepsis and antisepsis.

HBsAg, Anti-HCV and Anti-HIV Seroprevalance Among Drug Users: a Retrospective Assessment.

Drug abuse and co-occurring infections are associated with significant morbidity and mortality. In regions with high rates of drug usage, infections like hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are highly prevalent. Epidemiological studies on HBV, HCV and HIV infections among users of illicit drugs are scarce in Turkey. The primary aim of this cross-sectional and retrospective study was to determine the hepatitis B surface antigen (HBsAg), anti-HCV antibody (anti-HCV) and anti-HIV antibody (anti-HIV) seroprevalences in drug users who applied to a psychiatric outpatient clinic of drug addiction of a university hospital. Secondarily, the assessment of HBsAg, anti-HCV and anti-HIV parameters among intravenous drug users was aimed. Serum samples of all patients on probation who applied to a psychiatric outpatient clinic of drug addiction of a university hospital between 2013-2017 and sent to the department of medical microbiology for routine serologic testing were included in the study. The serologic results were obtained retrospectively from laboratory records. For the statistical analysis of the data IBM SPSS 20.0 program was used. Among the studied individuals, the ELISA results demonstrated the existence of HBsAg, anti-HCV and anti-HIV in 94 out of 4357 patients (2.2%), 27 out of 4451 patients (0.6%) and 10 (0.2%) out of 4464 patients, respectively. According to the records, 17 of the patients reported intravenous drug usage. Among this patient group, three patients were found to be anti-HCV positive and one patient was found to be anti-HIV positive. In our study, the prevalence of HCV and HIV was increased in patients with intravenous drug usage, whereas in non-intravenous drug users the prevalence is similar to the normal population. In order to plan prevention and harm reduction services for this high-risk population, more national data is needed on HBV, HCV and HIV rates among this group.

О значении скрининга на наличие антител к ВИЧ у пациентов крупных многопрофильных стационаров

О значении скрининга на наличие антител к ВИЧ у пациентов крупных многопрофильных стационаров

Delayed Seroreversion in HIV-exposed Uninfected Infants.

Recent studies report delayed anti-HIV antibody clearance (seroreversion) among HIV-exposed uninfected infants that may affect diagnostic practices. We evaluated the age-specific seroreversion rates in Thailand. The medical records of HIV-exposed uninfected infants born in January 2000-December 2014 were reviewed. Anti-HIV seroreversion rates at 12, 18 and 24 months were analyzed in 3 periods according to the Thai National Guidelines of prevention of mother-to-child transmission of HIV: zidovudine with or without single dose nevirapine to all women (2000-2006), adding lamivudine plus nevirapine to zidovudine in women with CD4 count <200 cells/mm (2007-2009) and zidovudine plus lamivudine plus boosted lopinavir to all women (2010-2014). In 2013, the serologic test kit was changed from third- to fourth-generation (4G) assay. All the infants were formula fed. Among 736 infants, the overall seroreversion rates at 12, 18 and 24 months of age were 59.38%, 94.57% and 100%, respectively. The seroreversion rates at 12 months of age declined from 68% in 2000-2006 and 65.9% in 2007-2009, to 42.9% in 2010-2014 (P = 0.001). Seroreversion rates at 18 months of age were more than 96.5% before 2013 and decreased to 79.1% in 2013-2014 (P = 0.001) with use of 4G. Multivariate analysis identified antepartum protease inhibitors treatment and the use of 4G testing as independent factors associated with delayed seroreversion. Anti-HIV seroreversion delay in HIV-exposed uninfected infants was associated with use of protease inhibitors and 4G HIV testing, complicating the interpretation to exclude perinatal HIV infection.