Generation ELISA Research Articles

HIV Sero-Prevalence among Tuberculosis Patients in Bangladesh: a nationwide cross-sectional study

Introduction Bangladesh is committed to achieving the SDG target of ending the tuberculosis epidemic and achieving UHC by 2030. To inform policy and program decision-making, this nationwide sero-survey of HIV among tuberculosis patients was conducted. Methods The cross-sectional survey utilized a two-stage probability proportional to size (PPS) systematic random sampling technique for selected TB reporting centers (TRCs) from June 2020 to December 2021. The estimated 12,065 diagnosed tuberculosis patients, according to the NTP diagnostic algorithm, irrespective of age and sex, were included. The required information was collected through face-to-face interviews and record reviews using a pre-tested electronic TAB-based semi-structured questionnaire. With all aseptic precautions for all respondents who gave consent, 5 ml. venous blood was collected for the standard confirmatory test by 4th generation ELISA method for detection of antibody of HIV1/2/P24 antigen. Results Out of 12,065 TB patients surveyed, most of them were from the Dhaka division (25%), urban (76%), 55 years and above (28%), male (56%), married (82%), illiterate (36%) and living in a nuclear family (70%). A total of 12 (0.1%) HIV-positive cases were found among TB patients across the country, and the majority (33%) of them belonged to the age group of 35 to 44 years, male (58%), lower educational group (67%), urban resident (67%), and from nuclear family (77%). The HIV-positive patients found more among pulmonary TB patients (83%) who were detected bacteriologically positive (58%) but smear and gene expert negative (75%). Among them, none was found to have progressed to drug-resistant TB. Conclusion HIV affects the immune system, and TB is one of the leading causes of death in HIV-infected people. Although the rate is low, there is a need for continued efforts to prevent and treat TB in Bangladesh, particularly among older age groups, urban residents, and those with co-morbidities such as diabetes.

Seroprevalence and risk factors of HBV, HCV and HIV among hemodialysis patients: a multicenter cross-sectional study from Damascus Syria

ObjectiveThe aim of this study is to determine the prevalence rates of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections among hemodialysis (HD) patients as well as to identify associated risk factors.MethodologyA multicenter cross-sectional study involved patients who had been on HD for at least three months. The study was conducted at five HD centers in Damascus, Syria from August 2019 to September 2021. HBsAg, HCV-Ab and HIV (antibody/antigen) seropositivity were identified using the third generation ELISA technique. Patients’ information was extracted from their records and by face-to-face interview. Multiple logistic regression models were applied to identify risk factors associated with HBV or HCV seropositivity. The significance level was set at 5%.ResultsA total of 637 patients were included in the study with a mean age (SD) of 50.5 (15.6) years and 56.7% of them were men. The dialytic age ranged from one to thirty years with a mean (SD) of 6.10 (5.6) years. The prevalence of positive hepatitis B surface antigen, anti-HCV, co-infection of HBV and HCV, and anti-HIV (antibody/antigen) were 3.2%, 22.1%, 0.7%, and 0%, respectively. After controlling for co-variables, hepatitis B vaccine was the only predictor of seropositivity of HBV (OR: 0.15, 95% CI: 0.057–0.393, P < 0.001), as it significantly protected against contracting HBV. On the other hand, the dialytic age (OR: 1.42, 95% CI: 1.12–1.94, P = 0.032) and the dialysis center were significant factors affecting the prevalence of HCV.ConclusionsThe prevalence of HCV and HBV infections among HD patients in Damascus, Syria has decreased remarkably compared with the results from 2001. Nevertheless, it is still considered relatively high. Thus, there is an urgent need to strengthen the prevention and control measures for viral infection transmission in HD centers in Damascus.

Hepatitis C virus infection associated with coronary and thoracic aortic atherosclerosis

BackgroundCoronary and thoracic aortic calcification was associated with stroke, coronary heart, and peripheral vascular disease. Hepatitis C virus (HCV) infection is significantly associated with insulin resistance, diabetes mellitus and hepatic steatosis. We aimed to investigate the relationship between HCV infection and coronary, thoracic aortic atherosclerosis. Materials and methodsCalcification was detected by chest computed tomography and defined as any Agatston score greater than zero. Metabolic syndrome was based on the modified Adult Treatment Panel III criteria. Fibrosis-4 (FIB-4) and AST-to-platelet ratio (APRI) was calculated. The anti-HCV signal-to-cutoff (S/CO) ratio was determined by the third generation ELISA kit. Atherosclerosis risk was estimated by using multiple logistic regression modeling. ResultsBeing positive for both metabolic syndrome and HCV infection (OR = 2.65, 95% CI: 1.26–5.59, p = 0.007), negative for metabolic syndrome and positive for HCV infection (OR = 2.75, 95% CI: 1.48–5.30, p = 0.001), and positive for metabolic syndrome and negative for HCV infection (OR = 2.42, 95% CI: 1.92–3.07, p < 0.001) were associated with atherosclerosis compared with being negative for both metabolic syndrome and HCV infection (Ptrend< 0.001). HCV infection with liver fibrosis (HCVFIB4>1.4; OR = 2.16, 95% CI: 1.22–3.82, p = 0.008), or (HCVAPRI>0.5; OR = 3.40, 95% CI: 1.28–9.06, p = 0.014) and elevated anti-HCV S/CO ratio (anti-HCVS/CO>10.0; OR = 1.72, 95% CI: 1.01–2.93, p = 0.045) was associated with atherosclerosis. ConclusionsHCV infection with metabolic syndrome, liver fibrosis and elevated anti-HCV S/CO ratio was associated with atherosclerosis.

Seroprevalence of Transmisive Diseases in Healthy Blood Donors: a Five-year Experience in University Clinical Center Tuzla.

The safety of blood products is the most important task of transfusion medicine. Transfusion-transmitted diseases represent a serious public health problem throughout the world, although their percentage of transmission is minimal. Each blood donation is individually tested with serological and molecular tests for the presence of hepatitis B and C viruses, human immunodeficiency virus (HIV), and Treponema Pallidum, regardless of the number of blood donations. To determine the seroprevalence of blood-borne diseases in healthy blood donors at the University Clinical Center Tuzla, to analyze the possible causes of transmission of these diseases, and to compare with the results of research in countries in the region and beyond. The research was conducted retrospectively in the period January 1, 2018. until 31.12.2022. years. Samples of blood donors were tested for hepatitis B surface antigen (HBsAg), antibodies to human immunodeficiency virus (HIV1/2), antibodies to hepatitis C and syphilis, using the fourth generation ELISA method. The highest frequency of transmisive disease markers was reactivity to HBsAg with a total of 63.7% of cases and a prevalence of 0.13%, and the lowest for HIV with a total of 1.4% and a prevalence of 0.003%. Bosnia and Herzegovina has a very low seroprevalence but there is still a risk of disease transmission in the population.

Evaluation of Sensitivity and Specificity of Third and Fourth Generation ELISA in detecting Hepatitis B Virus among Blood Donors

&lt;p&gt;&lt;strong&gt;Aim&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;To compare the 4th generation ELISA with 3rd generation ELISA for early detection of HBV infection among voluntary blood donors and for specificity.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Material and methods&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;779 samples of voluntary blood donors were tested for HBsAg by 3&lt;sup&gt;rd&lt;/sup&gt; generation ELISA and 4&lt;sup&gt;th&lt;/sup&gt; generation ELISA.&lt;/p&gt; &lt;p&gt;The results were compared and discrepant samples were further tested by NAT (RT-PCR) and HBe antigen and HBc antibody by CMIA.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Results&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;279 were found HBsAg reactive and 500 samples were found non-reactive by third generation ELISA.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Out of these 279 we found 3 samples to be non-reactive by fourth generation ELISA&lt;/strong&gt;.&lt;/p&gt; &lt;p&gt;Discrepant samples were then tested for NAT which also gave comparative results with fourth generation ELISA. Two samples were further tested for marker study. Marker study also showed that these two samples were negative for HBV infection.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;&lt;/p&gt; &lt;ul&gt; &lt;li&gt;The results of 4th generation ELISA, NAT and HBV markers were found comparable in our prospective study&lt;/li&gt; &lt;li&gt;We had 3 false positives with III generation&lt;/li&gt; &lt;li&gt;Thus 4&lt;sup&gt;th&lt;/sup&gt; generation kit for HBsAg is more specific than 3&lt;sup&gt;rd&lt;/sup&gt; generation ELISA and comparable with better method like NAT.&lt;/li&gt; &lt;li&gt;In India where NAT testing is costly and not mandatory, 4&lt;sup&gt;th&lt;/sup&gt; generation ELISA can be preferred as it is will decrease false positive and rejection of donors&lt;/li&gt; &lt;/ul&gt;

Prevalence and Associated Risk Factors of HCV Infection Among Children in Lahore, Pakistan

Background: Pakistan has second highest prevalence of HCV in the world. The epidemiology and burden of HCV infection varies in people of different ages. Objective: Present study was designed to measure the prevalence of HCV among children in selected public&#x0D; and private hospitals of Lahore Methods: Children in the study were screened for anti-HCV test through ELISA (third generation ELISA Kit&#x0D; and Qaigen kit) for detecting the viral load from June 2018 to May 2019. Results: Children in the study were screened for anti-HCV test through ELISA (third generation ELISA Kit and Qaigen kit) for detecting the viral load. The average age of non-reactive and reactive children was 7.28±3.36 and 5.50±3.8 years respectively. Socio-economic status was found associated with anti-HCV. An association was found significant for birthplace, delivery assisted by, and type of milk given to the child. Conclusion: This study shows that the prevalence of HCV is 3.85% in children in lahore city of Pakistan, which is alarming situation for healthcare providers, researchers and policy makers.

Does testosterone intake affect diagnosing primary HIV infection?

Diagnosis of primary HIV infection may be disrupted by many factors, one of which are drugs such as exogenous steroids. We report a rare case of a 37-year-old male patient, undergoing testosterone treatment in the course of Klinefelter syndrome. He presented with the general symptoms of fever, weakness and diarrhea lasting for 2 weeks. He also had incorrect results of laboratory studies. The fourth generation ELISA HIV test indicated negative outcomes. The HIV real time polymerase chain reaction test was performed and showed very high plasma viral load, over 107 copies/ml. We discuss the connection between androgen replacement therapy used in Klinefelter syndrome and the diagnosis of PHI. This case report illustrates the importance of obtaining a detailed medical history, especially of chronic diseases and medications, and applying appropriate diagnostic tests.

Evaluation of Acute Human Immunodeficiency Virus Infection Cases

Objective: Acute HIV infection (AHI) is a stage with a rapid decrease in CD4+ T lymphocyte count, high viremia, and high transmissibility. Early diagnosis of AHI represents an opportunity for treatment and prevention of transmission. Therefore, we aimed to determine the clinical and laboratory findings in patients with acute HIV infection. Methods: Patients diagnosed with AHI among newly diagnosed HIV-infected patients were evaluated in the study. AHI diagnosis was defined as an HIV RNA result of at least 10,000 copies/ml with one of the following criteria: a negative or indeterminate HIV antibody test result in a person with a reactive Ag/Ab test result or a patient with a negative Ag/Ab test result has HIV RNA detected in serum or plasma or HIV serology positivity in a patient with signs and symptoms of AHI starting 2-6 weeks after high-risk HIV exposure. In addition, the history, clinical, and laboratory findings of patients with AHI were analyzed retrospectively. Results: One hundred six patients had a new HIV diagnosis during the study period. Of those, 12 (11.3%) were AHI. 10 (83.3%) of the patients with AHI were male, and seven were men who had sex with men. The mean age of the patients was 30 (21-50) years. Fourth-generation ELISA was negative in one patient initially; the repeated test was positive ten days later. While the 4th generation ELISA test of two patients was positive at the time of diagnosis, the confirmation test result was indeterminate. The 4th generation ELISA test was positive in nine patients with AHI symptoms starting 10-30 days after unprotected sexual intercourse. The duration of the patient’s complaints until the admission was found to be 13 (7-30) days. The most common findings were fever, diarrhea, fatigue, sore throat, lymphadenopathy, rash, nausea, and vomiting. Conclusion: The AHI rate was 11.3% in newly diagnosed cases of HIV infection. Awareness of AHI’s signs and symptoms to initiate early diagnosis and treatment. Thus, a better HIV infection course and reduced HIV transmission can be achieved.

SEROPREVALENCE OF TRANSFUSION TRANSMISSIBLE INFECTIONS AMONG BLOOD DONORS AT A TERTIARY CARE TEACHING HOSPITAL IN AJMER, RAJASTHAN: A 5 YEAR STUDY

Objective: The objective of the study was to study the seroprevalence of TTIs (transfusion transmissible infections) among blood donors from the records (June 2017–May 2022) at blood center, JLN Hospital and associated group of Hospital, Ajmer, Rajasthan. Methods: A cross-sectional study was carried out over a period of 5 years from June 2017 to May 2022. Serum samples were screened for hepatitis B virus (HBV), hepatitis C virus (HCV) (III generation ELISA), antibodies to human immunodeficiency virus (HIV) Type 1 and 2 (IV generation ELISA kits), Syphilis and Malaria parasite using modified Treponema pallidum hemagglutination test and rapid card test, respectively. Results: A total of 75,034 healthy donors were included out of which majority of donors were male (97.4%). The overall seroprevalence of HIV, HBV, HCV, Syphilis, and Malaria were 0.07%, 0.71%, 0.06%, 0.29%, and 0.05%, respectively. Conclusion: Methods to ensure a safety blood supply should be encouraged. The increase in public awareness regarding voluntary blood donation, meticulous donor screening, counseling and use of highly sensitive tests can help in reducing the risk of TTIs.

UTILITY OF MINI-POOL NAT STRATEGY FOR IMPROVING BLOOD SAFETY BY DETECTING OCCULT HEPATITIS B VIRUS INFECTION : A 5 YEAR STUDY

Introduction: The prevalence of transfusion transmitted infections (TTIs) is high in India. The aim of our study was to evaluate the sero-prevalence of TTIs using Nucleic acid technology (NAT) and detection of Occult Hepatitis B virus infection by Minipool NAT Strategy. A total of 89,639 units of blood donated at Dhanvanta Materials and Methods: ri Voluntary Blood Bank, Rajahmundry during the period from January 2012 to July 2016. The sero-prevalence for HIV, HBV and HCV was tested by 4th generation ELISA. Only sero-negative samples were tested on mini pool nucleic acid test (MP-NAT) to detect HIV1, HIV2, HCV and HBV viral nucleic acids. Combined NAT yield was calculated and compared the NAT yield with MPX test and MPX V2.0. We also evaluated the optical density (OD) values of ELISA for MP-NAT reactive donor samples to evaluate the efcacy of NAT in detecting window period cases. The Results: overall sero-prevalence of TTIs was 2.41% and HBV was predominantly present (66%). Total 29 ELISA negative blood donor samples were found reactive on NAT. All NAT reactive donors were of HBV only. Out of 29 cases, 12 were detected by MPX test from 26,008 donations and 17 by MPX V2.0 from 25,619 donations, providing NAT yield of 1:2169 and 1:1507 respectively. OD and Signal cut off values of ELISA for NAT reactive samples were found to be much below extended grey zone value (&lt;0.3). Additiona Conclusion: l testing of nucleic acids by MP-NAT in combination of mandated primary serology by ELISA provides 99.99% of safe blood to needy patients; thus signicantly reduces the risk of TTIs by identifying the window period cases.

Performance characteristics of two new rapid HIV diagnostic assays and use of test band reader

PurposeAccurate HIV diagnosis is essential for appropriate patient care. This present study evaluated the performance of two different new rapid HIV diagnostic tests; 1) TRUSTline HIV-1/2 Ab rapid test (Athenese-DxPvt. Ltd, Chennai, India)and 2) OnSite HIV 1/2 Ab Plus Combo Rapid Test (CTK Biotech Inc., San Diego, USA) and also validated ALTA Rapid Test Reader (RTR-1) (CTK Biotech Inc., San Diego, USA), the device is a user-friendly and image-analysis based qualitative/semi-quantitative tabletop reader. MethodsA total of n ​= ​500 characterized specimens were used for this evaluation and the results of the new test kits (TRUSTline and OnSite) were also compared with 4th generation ELISA kit (Genescreen™Ultra HIV Ag-Ab ELISA) and 3 other commercially available rapid tests that were in the market; 1)SD Bioline™ HIV 1/2 3.0, 2) Aspen® HIV 1/2 Rapid Ab Test and 3) Diagnostic enterprises HIVTRI-DOT. The test band intensities of the TRUSTline and OnSite tests were measured in an ALTA rapid test reader and compared with the naked eye reading. ResultsThe sensitivity, specificity, positive predictive value, negative predictive value and efficacy of TRUSTline and OnSite were 100%, 99.6%, 99.5%, 100% and 99.8% and 100%, 100%, 100%, 100% and 100% respectively. ConclusionsThe ‘TRUSTline HIV-1/2’ and ‘OnSite HIV 1/2' kits are suitable to use in the HIV testing algorithm. Use of the ALTA rapid test reader could be user's friendly in the field level testing in resource-limited settings”.

Laboratory Evaluation of Hepatitis C Virus Infection in Patients Undergoing Hemodialysis from North East India

Subjects undergoing hemodialysis have enhanced vulnerability to hepatitis C virus (HCV) infection due to invasive procedures and poor infection control practices. Early detection and treatment are essential to prevent cross-infection and mortality/morbidity. However, common use anti-HCV antibody tests lack the necessary accuracy, and alternative tests (e.g. core antigen detection kits) which are available need to be examined as a viable alternative. A total of 270 continuous serum samples were collected from patients undergoing dialysis within 15 months of study period. Sequentially, multiple tests were performed - immunochromatography-based rapid test, third-generation ELISA i.e. (anti-HCV antibody detection), fourth-generation ELISA (HCV antigen-antibody combined detection assay), and HCV RNA quantitative real time polymerase chain reaction (qPCR) assay. Diagnostic parameters of serological kits were compared in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and so on. Statistical Package for the Social Sciences was used. HCV-combined core antigen-antibody assays performed better than other serological assays in reference to the gold standard HCV RNA. This fourth-generation assay yielded a Kappa value of 0.947 compared with the value of 0.747 and 0.619 for anti-HCV ELISAand rapid detection test. Other parameters such as sensitivity, specificity, PPV, NPV, and so on were also better for fourth-generation ELISA compared with third-generation ELISA and other serological assays. HCV RNA was negative in 7.3% of anti-HCV-positive patients and was detected in 11.4% of anti-HCV ELISA-negative patients. In about 1.6% of HCV RNA-positive cases, fourth-generation ELISA was negative and had low HCV viral load (650 IU/ml and below). Fourth generation ELISA detected additional 7.4% HCV positive cases (compared to third generation kits) and upon cost effective analyis, additional cost to be bear for the better detection (by fourth generation kit) was found to be only INR 27 per 1% increased case detection. In resource scant setup, screening and follow-up of patients undergoing hemodialysis can be performed by fourth-generation HCV ELISA (antigen-antibody combined assay) instead of the current practice of anti-HCV antibody ELISA. Better yield in detection rate will compensate for slight addition to costs.

CORRELATION BETWEEN THE ANTIBODY RESPONSE TOWARD SPECIFIC HCV PROTEINS AND HCV VIRAL LOAD

Background: Hepatitis C virus (HCV) is an RNA virus causing acute or chronic infection and affecting more than 2% of population worldwide. The firstline tests for diagnosis of HCV infection are 3rd or 4th generation enzyme immunoassays - ELISA and CIA. They indicate the presence of antibodies against HCV in serum. These tests are characterized by high sensitivity and specificity, but they cannot distinguish past, acute or chronic infection, and sometimes produce false positive results. Confirmatory tests, such as recombinant immunoblot-line immune assay (LIA), and quantitative PCR, are used to validate the positive antibody response. The recombinant immunoblot assay can be used to determine the specificity of antibody to HCV. The aim of the present study is to determine the correlation between the anti-HCV response in confirmatory immunoblot assay and the HCV viral load, measured by PCR. Materials and methods: Twenty-nine anti-HCV positive sera were included in the study. Third generation ELISA assay was used for anti-HCV screening of the samples and for detection of anti-HCV antibodies against specific HCV proteins. Third generation line immunoassay INNO-LIA HCV Score, based on the principle of an enzyme immunoassay, was used as a confirmatory test. The HCV viral load was measured by quantitative PCR method – Abbott Real Time HCV (Abbott Molecular Inc., USA) with linear sensitivity range from 1.08 Log 10 IU/ml (12 [IU/ml]) to 8.00 Log 10 IU/ml (100 000 000 [IU/ml]). Results: HCV RNA was quantified in all studied samples. Ten of 29 serum samples (34%, Group I) were HCV RNA negative. The rest of the samples were HCV RNA positive as follows: 3 serums were with minimal viral load from &lt; 12 to 10 000 IU/ml (10%, Group II); 3 serum samples –between 10 000 and 100 000 IU/ml (10%, Group III); 10 serum samples – between 100 000 and 1 000 000 IU/ml (34%, Group IV) and in 3 serum samples HCV RNA concentration was over 1 000 000 IU/ml (10%, Group V). Conclusion: HCV screening strategies involving anti-HCV detection by ELISA combined with recombinant immunoblot assay can be the method of choice in laboratories with limited equipment and finances.

Retrospective Study of Blood Transfusion Transmitted Infections (HIV, HCV, HBV, Syphilis &amp; Malaria] among the Blood Donors in Dhiraj Hospital

A blood transfusion is a way of adding blood to your body after an illness or injury. It’s a kind of life savingprocedure. But this procedure also has life threatening hazards. Transfusion transmitted infections are one ofthe major side effects of blood transfusion. We can prevent them by proper screening of blood products andpublic awareness. To know about trend of transfusion transmitted infections (TTI) for the blood donors ofDhiraj hospital blood bank, the study was done.Method: Study was done including blood donors of age 18-65 years from 2011 to 2016 retrospectively.TTIs testing for HIV, HBV and HCV was done with 3rd generation ELISA but from the year 2016 onwards4th generation ELISA was used for HIV testing. Syphilis and malaria screening was done with rapid cardtest.Result: Over a six year period total blood donation was 20,392. The overall prevalence of HIV, HbsAg,HCV, syphilis and malaria were 0.16%, 1.43%, 0.10%, 0.61% and 0.009% respectively.Conclusion: Nucleic acid amplification testing (NAT) must be applied that identify positive blood donorduring the immunological window period before seroconversion. Information to TTIs reactive donor is abest method to prevent the chance of repeated reactive donation.

COMPARISON OF FOURTH GENERATION ELISA AND RAPID DIAGNOSTIC TEST FOR DIAGNOSIS OF HEPATITIS C VIRUS(HCV) INFECTION IN A TERTIARY CARE HOSPITAL.

Introduction:Hepatitis C virus (HCV) infection has emerged as one of the major global health challenge affecting about 2 - 3% of the world population. Epidemiological studies have shown that HCV infection is a major risk factor for development of Acute hepatitis,chronic liver disease,cirrhosis and Hepatocellular carcinoma (HCC).Early diagnosis of HCV is important to link hepatitis testing to care and treatment initiation. Aim:To compare sensitivity and specificity of rapid diagnostic test (RDT) with fourth generation ELISA Material and Method: This study was conducted in the Department of Microbiology at Atal Bihari Vajpayee Institute of Medical Sciences (formerly Post Graduate Institute of Medical Education and Research) and Dr Ram Manohar Lohia Hospital from January 2018 to December 2018.Blood samples of patients suspected with hepatitis were tested using ELISA and rapid diagnostic test Results: In our study 26378 blood samples were tested for HCV,using fourth generation ELISA.Of these,581(2.20%) samples were found to be positive by ELISA.These HCV positive samples along with equal number of ELISA negative samples were tested by rapid diagnostic test. Sensitivity and specificity of the rapid diagnostic test was found to be 72.98 % and 100% respectively. Discussion:Rapid diagnostic test can be used during emergency hours but their results must be followed by ELISA test results in a tertiary care hospital.Reporting of false negative results should be minimized for rapid linkage to treatment initiation and to avoid silent transmission of infection.

HIV-1/2 differentiation in a South African public laboratory.

BackgroundThe human immunodeficiency virus type-2 (HIV-2) prevalence in South Africa (SA) is unknown, however, sporadic cases have been reported. Human immunodeficiency virus -1 and 2 differentiation is not part of most South African public laboratories’ testing algorithm. Human immunodeficiency virus -2 diagnosis using serology assays may be complicated by HIV-1 and HIV-2 antibody cross-reactivity.ObjectivesTo determine the proportion of HIV-2 infections in specimens that tested HIV-1/2 positive at a public laboratory in Tshwane.MethodA total of 480 specimens that were previously tested with fourth generation ELISA platforms (Modular E170 [Roche, Switzerland] and Architect i2000 [Abbott, Germany]) were randomly selected. Human immunodeficiency virus -1 and 2 antibody differentiation testing was carried out using the Multispot HIV-1/2 rapid assay (Bio-Rad Laboratories, USA). An in-house nested HIV-2 PCR assay targeting the 5′-long terminal repeats (5′-LTR) region was evaluated and used as a confirmatory test.ResultsThe study tested 480 HIV-1/2 seropositive patients and their mean age was 36.7 years (range 3–82 years). Of the 480 patients, 292 (60.8%) were female, 182 (37.9%) were male and 6 (1.3%) were not specified. Human immunodeficiency virus differentiation results were as follows: 466 (97.1%) were positive for only HIV-1 antibodies, 11 (2.3%) [95%CI: (0.98%; 3.74%)] were positive for both HIV-1 and HIV-2 antibodies, 3 (0.6%) were negative for both antibodies and none were positive for only HIV-2 antibodies. Of the 11 specimens with both HIV-1 and HIV-2 antibodies, seven had sufficient volume for confirmatory testing and were all negative on the in-house HIV-2 PCR assay.ConclusionThe multispot HIV-1/2 rapid assay demonstrated cross-reactivity between HIV-1 and HIV-2 antibodies. Human immunodeficiency virus -2 infections were not detected.

Immunochromatographic Test and Third Generation ELISA for Elucidating the Existence and Risk Factors of Anti-HCV Antibodies among Blood Donors from Swabi Pakistan

This cross sectional study was designed to investigate the frequency and potential risk factors of anti-HCV among blood donors as well as to elucidate the most sensitive screening method for routine practice in Bacha Khan Medical Complex (BKMC) Shahmansoor and District Head Quarter (DHQ) Hospital Swabi, Khyber Pakhtunkhwa Pakistan. A total of 3390 male volunteer blood donors with age range 18-55 years were screened for HCV-Ab through an immuno-chromatographic test (ICT) and 3rd generation-enzyme-linked immunosorbent assay (ELISA). The sensitivity of ICT and ELISA was also evaluated by comparing their results. Among 3390 donors, 59 (1.74 %) were found positive for HCV-Ab through ICT and 62 (1.82 %) were HCV-Ab positive by ELISA assay. The highest frequency rate (40.3 %) was observed among donors within the age group of 18-30 years followed by (27.4 %) among 31-40 years, (17.7 %) among 41-50 years and the lowest frequency (14.5 %) was found among 51-55 years. Dental treatment (37.0 %) was significantly associated with anti-HCV seropositivity followed by blood transfusion (20.9 %), major surgery (14.5 %), travel abroad and unknown reason (11.2 %) for each and the lowest anti-HCV association was observed among donors who shaved by the barbers (4.8 %). The results from ICT and ELISA indicated that ELISA is a more sensitive, and reliable technique for routine screening of blood donors to control infectious diseases particularly HCV infection.

Evaluation of the efficiency of the various techniques used for screening of HIV in antenatal mothers to facilitate early initiation of treatment

The study has been conducted in pregnant women in the high risk category attending the antenatal O.P at M.N.R Hospital and medical college and Niloufer Hospital for a defined period. The screening tests for HIV used are Coombaids, (Dot Immunoassay), as per NACO guidelines & Fourth- Generation (double antigen/antibody Sandwich with solid micro wells pre-coated with Recombinant HIV-1gp41, HIV-1 Group O gp41, HIV-2 gp36, & amp; Monoclonal Anti p24 Antibodies. The individual sensitivity and specificity were evaluated and compared. The sera of all the women screened by COOMBAIDS were tested negative & out of all the negative samples one sample was tested positive by 4th generation ELISA. Hence, this study was carried out to evaluate the sensitivity and specificity of various techniques for Antibody detection and Antigen detection, and to determine the technique most suitable for early diagnosis of HIV infection.4 Keyword: Antenatal women, Specificity and Sensitivity.

Genotyping and prevalence of hepatitis c virus in dialysis patients in Gandhi general hospital - A tertiary care centre

Context: The present study was undertaken to determine the genotyping and prevalence of hepatitis c virus in dialysis patients as HCV genotyping has become a part of the pre-treatment evaluation. Studies correlating risk factors and genotypes of HCV infection prevalent in Haemodialysis patients are scanty. Therefore our study is conducted to study the prevalence, genotypes and risk factors in order to detect and try to curb HCV infection. Aims: To study the genotypes of hepatitis C infection and its prevalence in hemodialysis patients. Settings and Design and Period: Study was conducted in Gandhi hospital Secunderabad in 1 year period as Cross-sectional study. Materials and Methods: A total of 225 serum samples were collected from chronic renal failure patients who were undergoing Haemodialysis over a period of 1 year. The samples were screened for anti HCV antibodies by third generation ELISA test. 25 anti-HCV positive samples and 40 anti-HCV negative samples were randomly selected for HCV RNA detection using Trizol-Chloroform-Isopropyl alcohol method, HCV RNA was reverse transcribed with 200 U of maloney murine leukemia virus reverse transcriptase and random hexamers. Nested PCR was done. HCV RNA positive samples were genotyped with primers specific for core region of different HCV types by type specific PCR. Statistical Analysis Used: Statistical analysis of the data was done by chi-square (c2) test using EPIINFO 2000 software. The values of chi square test are interpreted as not significant >0.05, highly significant < 0.001. Results: Out of 225 hemodialysis patients 38 (16.8%) patients were anti HCV positive. Duration of dialysis was significantly longer in anti-HCV antibodies positive group with dialysis duration more than 2 years. Seropositivity is more in HD patients having dialysis at more than one centre. HCV RNA was detected in randomly selected 13/25 (52%) anti HCV positive patients and in 5/40 (12.5%) anti HCV negative patients. The genotype distribution

Prevalence of hepatitis C among haemodialysis patients in a tertiary care hospital in south India.

Background and Objectives:Hepatitis C is the most common hepatotropic viral infection that affects patients on maintenance hemodialysis. Most of the laboratories in India depend on HCV antibody detection by ELISA. PCR based studies on detection of HCV RNA among haemodialysis patients are very scanty in India. The current study was undertaken to find the prevalence of HCV among haemodialysis patients by ELISA and PCR.Materials and Methods:This prospective study was conducted from January to May 2018 in a total of 100 samples. Patients more than 18 years of age, who had undergone at least 15 sessions of dialysis were enrolled in the study. All samples were screened for HCV antibody by ELISA and HCV RNA by PCR. Data regarding age and gender of the patients, history of blood transfusion, duration of hemodialysis, total bilirubin levels were collected from medical records.Results:Among the 100 samples, only one was positive for HCV antibody by ELISA. Eight samples were positive for HCV RNA by PCR. In this study 62.5% of the HCV positives had a previous history of blood transfusion. Duration of dialysis was more among the HCV positive group but there was no statistical significance.Conclusion:This is the first study from the southern state of Kerala in India showing the prevalence of HCV among hemodialysis patients by PCR. Our study showed an overall HCV prevalence of 8% by PCR. All the PCR positive samples were negative by 3rd generation ELISA which is an alarming finding and further justifies the need for PCR for detecting HCV.