Detection Of HIV Antibodies Research Articles

HIV self-testing strategy: implementation in Latin America and Mexico. Where are we going

HIV/AIDS emerged in the 1980s and created an urgent need for detection tests. Laboratory tests to detect HIV antibodies in blood samples were developed, followed by rapid tests in the 1990s. In the 2000s, HIV self-testing kits were introduced, improving accuracy and ease of use. Self-testing has become crucial in the fight against HIV. By 2030, the United Nations Programme on HIV/AIDS (UNAIDS) sets goals for detection and treatment. Despite progress, challenges such as stigma and education persist. In Latin America, national self-testing programs are being implemented, such as in Chile, Brazil, and Colombia. In Mexico, the approval of self-tests in 2024 represents a significant advancement. Self-tests are expected to be widely used to detect the disease early, ensuring privacy and reducing stigma and discrimination. They will also be used for research in vulnerable groups and to refer patients to pre-exposure prophylaxis (PrEP) services. With these actions, the aim is to achieve the goals set by UNAIDS and improve public health in the fight against HIV.

External quality assessment to support the WHO ProSPeRo study for the evaluation of two dual HIV/syphilis point-of-care tests in seven countries

BackgroundSexually transmitted infections (STIs) such as syphilis and HIV remain to be a significant public health issue worldwide. Dual rapid point-of-care tests (POCTs) have shown promise for detecting antibodies to HIV and syphilis but have not been fully evaluated in the field. Our study supported the WHO ProSPeRo study on Sexually Transmitted Infection Point-of-Care Testing (STI POCT) by providing external quality assessment (EQA) for HIV and syphilis testing in reference laboratories and their associated clinical sites in seven countries.MethodsHIV/syphilis serum liquid and dried tube specimen (DTS) panels were prepared by CDC. Liquid panels were distributed to the reference laboratories for three rounds of testing using commercially and locally available laboratory-based serological tests. DTS panels were sent to the clinical testing sites for 8 rounds of POC testing using the Abbott SD BIOLINE HIV/Syphilis Duo test (hereafter referred to as SD BIOLINE) and the Chembio Dual Path Platform (DPP) HIV-Syphilis assay. EQA panels were tested at CDC using the Rapid Plasma Reagin (RPR) test and the Treponema pallidum Particle Agglutination assay (TP-PA) for syphilis antibodies. Genetic Systems HIV-1/HIV-2 Plus O EIA, Geenius HIV Supplemental Assay and the Oraquick Advance HIV test were used to detect HIV antibodies in the EQA panels. Results from the reference laboratories and POCT sites were compared to those obtained at the CDC and a percentage agreement was calculated.ResultsQualitative RPR and TP-PA performed at the reference laboratories demonstrated 95.4–100% agreement with CDC results while quantitative RPR and TP-PA tests demonstrated 87.7% and 89.2% agreement, respectively. A 93.8% concordance rate was observed for qualitative HIV testing in laboratories. EQA testing at clinical sites using dual tests showed 98.7% and 99.1% agreement for detection of HIV antibodies and eight out of 10 sites had > 95.8% agreement for syphilis testing. However, two clinical sites showed only 65.0–66.7% agreement for SD BIOLINE and 84.0–86.7% for DPP, respectively, for syphilis testing.ConclusionsOverall, laboratories demonstrated high EQA performance in this study. Both HIV/syphilis POCTs gave expected results in the clinic-based evaluations using DTS. However, testing errors were identified in a few testing sites suggesting the necessity for continuous training and monitoring the quality of POC testing.

Evaluation of the accuracy of the Asanté assay as a point-of-care rapid test for HIV-1 recent infections using serum bank specimens from blood donors in South Africa, July 2018 - August 2021.

Point-of-care (POC) rapid recency testing can be used as a cost-effective tool to identify recently infected individuals (i.e. infected within the last 12 months) in near-real time, support epidemic control and identify hotspots for transmission as part of recent infection surveillance. To evaluate the performance of the Asanté (HIV-1) rapid recency assay as a POC rapid test among blood donors in South Africa (SA). The study was a cross-sectional and validity study of the Asanté HIV-1 Rapid Recency Assay performed on 715 consecutively archived plasma donor specimens from the SA National Blood Services to determine their recency and established HIV infection status. ELISA and rapid assays for HIV antibody detection were used as the reference-testing standard for confirming an infection, while the Maxim HIV-1 limiting antigen (LAg) avidity assay was used as a reference for comparing HIV recency status. Validity tests (sensitivity, specificity, negative and positive predictive values) and Cohen-Kappa tests of the agreement were conducted to compare the Asanté HIV-1 rapid recency assay results with the reference tests. Of the 715 studied blood samples, 63.1% (n=451/715) were confirmed to be HIV-positive based on the reference standard. The sensitivity and specificity of the Asanté HIV-1 rapid recency assay in diagnosing established HIV infection compared to the ELISA were 98.4% (95% CI 96.7 - 99.3) and 99.6% (95% CI 97.6 - 100), respectively. Compared with HIV rapid assay, the sensitivity and specificity of the Asanté HIV-1 rapid recency assay was 98.7% (95% CI 97.0 - 99.4) and 99.2% (95% CI 97.1 - 100), respectively. Of the 451 HIV-positive blood samples, 43% were confirmed as recent HIV infections by the Maxim HIV-1 LAg avidity assay. There was high agreement between the Asanté HIV-1 rapid recency assay and the Maxim HIV-1 LAg avidity assay (94.1%, k=0.879, p<0.0001). The sensitivity and specificity of the Asante HIV-1 assay was 89.4% (95% CI 84.0 - 93.0) and 97.7% (95% CI 94.8 - 99.0), respectively. The Asanté HIV-1 rapid recency assay test results demonstrated high accuracy (>90%) compared with the HIV ELISA and rapid assays for determining established infection and the Maxim HIV-1 LAg avidity assay for classifying recent HIV-1 infections. The assay's sensitivity for established infections was below the World Health Organization criteria (<99%) for POC devices. The Asanté HIV-1 rapid recency assay can be used to distinguish between recent and long-term infections, but may not be considered a POC test for determining HIV infection.

Work experience and development of interaction between specialists of medical organizations in conducting dynamic monitoring of pregnant women in contact with HIV-infected sexual partners in the Saratov region

BACKGROUND: In HIV-discordant couples, questions often arise about the possibility of having a child. Under current conditions, with the availability of antiretroviral therapy, such couples can have healthy children, subject to specific requirements. No approved algorithm exists for examining and monitoring of pregnant women in contact with HIV infection.&#x0D; AIM: This study uses a team approach that comprises specialists from medical organizations to monitor discordant couples in which the man is HIV positive, and the woman is HIV negative at any stage of pregnancy.&#x0D; MATERIALS AND METHODS: A retrospective study was conducted from 2018 to 2021 from medical records of 158 discordant couples in which the man is HIV positive and the woman is HIV negative. The detection results of HIV infection were evaluated by detecting HIV antibodies, HIV DNA/RNA in healthy pregnant women and CD4 lymphocytes, and HIV RNA in HIV-infected sexual partners. Safety measures were observed for medical personnel and the patient during medical interventions.&#x0D; RESULTS: Discordant couples under observation were divided into 2 groups and totaled 158 couples. They included 69 (43.3%) couples who were observed at the Center for AIDS and were planning a pregnancy and 89 couples (52.9%) who first applied to the medical organization about a pregnancy that had already occurred. In the first group, sexual partners were on antiretroviral treatment until the wife became pregnant, and the viral load was undetectable. In 100% of cases, there was no HIV transmission to a woman in this group during pregnancy. In the second group, 52 (58.4%) HIV-infected sexual partners and 37 (42.5%) couples not receiving antiretroviral therapy received antiretroviral therapy. In the second group of discordant couples, HIV transmission was 1.1% (1 woman).&#x0D; CONCLUSIONS: It is necessary to develop, approve, and implement an algorithm that includes monitoring discordant couples from the moment they are registered, examining the sexual partners of pregnant women in 100% of cases, and developing a team approach to monitor pregnant women.

INVESTIGATIONS OF CHRONIC HEPATITIS B and C IN HIV-INFECTION

Relevance. Today, there are controversies regarding the influence of hepatitis B and C viruses on the course of HIV infection.&#x0D; Objective assess the course and outcomes of chronic hepatitis B and C in HIV-infected patients, as well as to analyze the causes of death of such patients.&#x0D; Materials and methods. A retrospective pseudorandomized study was conducted with a depth of 5 years. 114 medical records of inpatients (HIV infection in association with hepatitis B and C) were selected. The analysis of the causes of death in patients with HIV infection was carried out based on the study of autopsy materials of 21 patients.&#x0D; Results. It was established that the frequency of CHV exacerbation in III-IV clinical stages of HIV infection is significantly higher, and remission is lower than in I-II stages - (36.8±4.5) versus (7.0±2.4)% and (35.1±4.5) and (7.9±2.5)%, respectively (p&lt;0.001). The frequency of liver cirrhosis was characterized by a clear tendency to increase with the deepening of immunodeficiency.&#x0D; The calculation of the frequency of findings in liver cirrhosis showed that in the I-II clinical stage of HIV infection, this value was equal to 0.17, and in the III-IV stage - 0.33. The relative risk of developing liver cirrhosis in HIV-infected patients was 0.52. Moreover, the probability of a fatal outcome in cirrhosis of the liver in HIV-infected patients in the I-II clinical stage was equal to 0.16, and in the III-IV stage - 0.29, with a relative risk of 0.63. The reduction in the relative risk of a fatal outcome taking into account the stage of HIV infection is 0.32.&#x0D; The average life expectancy of patients from the moment of detection of HIV antibodies was (3.4±0.6) years (from 4 months to 9 years). Such a short average life expectancy of HIV-infected patients was caused by a large number of patients diagnosed for the first time already in the IV clinical stage. In more than half (13 out of 21) the causes of death were AIDS-related diseases (61.9 %).&#x0D; Conclusions. A retrospective pseudorandomized study showed that cirrhosis of the liver in the early stages of HIV infection was registered 2.7 times less often than in patients with HIV infection in the stage of secondary diseases.&#x0D; Exacerbation of chronic hepatitis B and C is significantly more often established in the III-IV clinical stage of concomitant HIV infection. Under the same circumstances, signs of cirrhosis of the liver are more often registered, and fatal outcomes occupy one of the leading places in patients with HIV infection. This indicates the need to revise the tactics of clinical management of this category of patients.&#x0D; In 61.9 % of cases, the causes of death were AIDS-indicative diseases. Tuberculosis turned out to be the leading cause of death (46.1 %) of HIV-infected patients and was mainly in a generalized form. Toxoplasmosis (30.8 %) with damage to the brain and other organs takes the second place in terms of the frequency of fatal AIDS-indicative diseases. Meningoencephalitis of unspecified (probably herpetic) etiology was found in 23.1 % of the deceased. An important place in the structure of fatal outcomes in HIV-infected patients is occupied by the terminal stage of cirrhosis of the liver of mixed etiology - viral and alcoholic (38.1 %).

Evaluation of the bioMérieux VIDAS HIV Duo Quick and Anti-HCV assays for dried blood spot based serosurveillance

Serosurveillance is central to monitoring our progress towards HIV and HCV elimination targets proposed for 2030. However, serosurveillance systems are ineffective without reliable serological assays for the detection of HIV and HCV antibodies. Assays should also be compatible with dried blood spot (DBS) samples to facilitate biological sample collection. The VIDAS HIV Duo Quick and Anti-HCV assays are sold as reagents strips and processed by the automated VIDAS benchtop immunoanalyser. While both assays have shown excellent performance in serum and plasma, performance data in DBS samples is lacking. In our study, we evaluate the performance of the VIDAS HIV Duo Quick and Anti-HCV assays in DBS (n = 725) collected during a cross-sectional serosurvey (the Transitions study). The VIDAS HIV Duo quick had a sensitivity and specificity of 94.5% (95% CI 85.1%, 98.5%) and 95.7% (95% CI 93.9%, 97.0%) respectively. Likewise, the VIDAS Anti-HCV had a sensitivity and specificity of 95.6% (95% CI 91.6%, 97.8%) and 95.6% (95% CI 93.5%, 97.0%) respectively. These assays are unlikely to be helpful in low-prevalence settings due to sub-optimal performance, but their performance could likely be improved by optimizing DBS elution protocols which was, unfortunately, not possible during our study.

Validation study of an automated chemiluminiscence assay to detect HIV antibodies in oral fluid specimens.

Oral fluid specimens (OF) have been widely used to know the HIV prevalence in several key populations. Here, we aim to validate in OF specimens an existing HIV chemiluminiscence assay for serum specimens. Paired OF and serum specimens were collected from 83 known HIV-positives and 83 known HIV-negatives in order to validate the performance characteristics of the automated chemiluminiscence Liaison XL Murex HIV Ag/Ab assay (Diasorin Inc, Iberia) for HIV antibody detection in OF specimens. Among the previously known HIV-seropositive group, HIV antibodies were detected in 69 out of 83 OF specimens. All serum and OF specimens collected from 83 HIV seronegative individuals were negative. The sensitivity and specificity of this assay were 83.13% and 100% respectively in OF. The PPV and NPV values were 100% and 85.57% respectively. The correlation obtained between both specimens was (K: 0.83, [95% CI: 0.748–0.915]) according to the kappa index. The ROC curve analysing the optimal cut-off of the Liaison XL Murex HIV Ag/Ab to detect positive OF specimens revealed that a cut-off of 0.497 showed sensitivity and specificity values of 98.8% and 97.59% respectively. Taking into account this cut-off, the overall sensitivity and NPV of the Liaison XL Murex HIV Ag/Ab assay could rise from 83.1 to 98.8% and from 85.5 to 97.7%, respectively. Our results suggest that the Liaison XL HIV Ag/Ab assay is suitable for the detection of HIV antibodies in OF specimens.

A pilot study to assess the performance of a rapid ultrasound particle agglutination method for the detection of HIV antibodies

ABSTRACT Anti-HIV antibody screening and confirmatory tests include rapid diagnostics tests (RDT), which have limited sensitivity, and high-sensitivity ELISA and western blot tests, which are laborious and require technical proficiency. Thus, there is an unmet need for novel rapid, simple, and highly sensitive tests. A pilot study was conducted to assess the performance of a recently developed ultrasound particle agglutination (UPA) method for high-sensitivity HIV antibody detection using 51 confirmed positive and 310 presumably negative plasma samples, and 6 commercially available anti-HIV-1 seroconversion panels (total 56 members). Optimal cutoff value of the UPA method was determined by receiver operating characteristics (ROC) analysis, providing clinical sensitivity and specificity of 100% and 98.1%, respectively. The performance characteristics of UPA, compared with those of some established RDT’s and ELISA tests using HIV seroconversion panels, showed 2 days earlier HIV antibody detection than other RDT’s and 2nd-generation ELISA, and at approximately the same time as 3rd-generation ELISA. The preliminary analysis of the UPA method performance characteristics showed that it meets the minimum requirements of the WHO guidelines for RDTs as first-line assays. This pilot study paves the way for more detailed validation studies of the UPA method for HIV antibody detection in clinical practice.

Laboratory-Based Evaluation of SD Bioline HIV/Syphilis Duo Rapid Test Kits in the Gambia, November 2019

Background: HIV and syphilis are mainly diagnosed using separate rapid test kits for the HIV counseling and testing (HCT), Prevention of Mother-to-Child Transmission of HIV (PMTCT) and other clinical requests in healthcare facilities in The Gambia, as recommended in the HIV testing management guidelines. The goal of this study was to evaluate the performance of SD Bioline HIV/ Syphilis Duo as a single test kit used for the simultaneous detection of HIV &amp; Syphilis antibodies in the laboratory setting. Methods: We determined the sensitivity, specificity, positive and negative predictive values of SD Bioline HIV/Syphilis Duo kits in terms of HIV screening against the GenScreen Ultra HIV Ag-Ab ELISA (Lot 9D0126) using a total of 100 HIV negative and 150 HIV positive serum/plasma specimens that were stored at -20°C. Subtyping of the HIV positive specimens was previously performed using First Response HIV-1/2 test cards and Western Blot assays respectively. Moreover, the SD Bioline HIV/Syphilis Duo kit sensitivity, specificity, positive and negative predictive values in relation to Syphilis screening of 100 specimens was also determined against Treponema Pallidum Heamagglutination Assay (TPHA). Results: In terms of HIV screening (n=250), the sensitivity, specificity, positive and negative predictive values of the SD Bioline HIV/Syphilis Duo Test Kits were 100%, 100%, 100%, and 100% respectively when compared with the GenScreen Ultra HIV Ag-Ab ELISA results in the laboratory setting. Sensitivity for Syphilis screening (n=100) was 95.65%, whilst specificity was 100% when compared with TPHA. Positive predictive value was 100%, whilst the negative predictive value was 98.86%. Conclusions: These findings show that the SD Bioline HIV/Syphilis Duo kits have high sensitivity and specificity when used for the detection of HIV and Syphilis antibodies using human serum and/or plasma. Therefore, these kits could serve as a good alternative for the dual elimination of mother-to-child transmission (e-MTCT) HIV and Syphilis through a one-step timely diagnostic procedure, which is crucial in reducing the turnaround time of laboratory test results.

Laboratory-based Evaluation of Wondfo HIV1/2 Rapid Test Kits in the Gambia, December 2020

Background: HIV rapid diagnosis in The Gambia is mainly done using Determine HIV-1/2 and First Response HIV 1.2.0 or SD Bioline HIV-1/2 3.0 for screening and sero-typing of HIV respectively among children and adults. Polymerase Chain Reaction (PCR) is used for the detection of the HIV viral genome among infants born to HIV positive mothers. This is the HIV testing Algorithm recommended in the HIV testing guidelines of The Gambia for both HIV Counseling and Testing (HCT), Prevention of Mother-to-Child Transmission of HIV (PMTCT) as well as other clinical requests for HIV testing. At the National Public Health Reference Laboratories (NPHRL), ELISA is the first line of testing for HIV while First Response HIV 1.2.0 or SD Bioline HIV 1/2 3.0 is used for preliminary serotyping. MP Diagnostics HIV Blot 2.2 Western Assay, which is the gold standard for HIV testing in The Gambia, is used as the tie breaker (i.e., when there are discordant results). The aim of this study was to evaluate the sensitivity and specificity of the Wondfo HIV 1/2 rapid test kit for the detection of human antibodies to HIV in serum/plasma/whole blood and dried blood spots. Methods: The sensitivity, specificity, positive and negative predictive values of Wondfo HIV 1/2 kits were evaluated in terms of HIV screening against Determine HIV1/2, GenScreen Ultra HIV Ag-Ab ELISA and First Response HIV 1.2.0 using a total of 401 samples. Of these, 351 were sera/plasma samples {100 HIV negative, 250 HIV positive and 1 indeterminate that were stored at -20°C, 26 were whole blood samples (4 negative, 22 positive), and 24 were dried blood spot (DBS) specimens (16 negative and 8 positive) were used for this evaluation. HIV positive specimens were previously sero-typed using First Response HIV-1.2.0 test cards and MP Diagnostics HIV Blot 2.2 Western Assay. Results: The evaluation shows that the sensitivity, specificity, positive and negative predictive values of Wondfo HIV 1/2 Test Kits with regards to HIV Screening when compared with the GenScreen Ultra HIV Ag-Ab ELISA and First Response 1.2.O (n=401) were 100%, 100%, 100%, and 100% respectively. Similarly, the sensitivity, specificity, positive and negative predictive values of Wondfo HIV 1/2 Test Kits with regards to HIV Screening compared to Determine HIV1/2 (n=401) were 99.64%, 100%, 100%, and 99.17% respectively. Conclusions: This study demonstrates that Wondfo HIV 1/2 test kits have a high sensitivity and specificity when used for the detection of HIV antibodies using human serum/plasma, whole blood or DBS.

Serosurvey of anti-treponema pallidum (syphilis), anti-hepatitis C virus and anti-HIV antibodies in homeless persons of São Paulo city, southeastern Brazil

Homeless persons have been considered as one of the most susceptible populations to sexually transmitted infections. In Brazil, these population experienced an increase of 140% from 2012 to 2020. Accordingly, the present study aimed to assess the seroprevalence of anti-Treponema pallidum, anti-HCV, anti-HIV antibodies, and the risk factors associated with homeless persons in a daytime attendance shelter of São Paulo city during the syphilis epidemic in Brazil. Blood samples of 116 volunteers and epidemiological data were conveniently collected in the shelter from June through August 2018. Detection of syphilis, HCV, and HIV antibodies was performed by chemiluminescent microparticle immunoassay (CMIA). CMIA-reagent samples for anti-T. pallidum antibodies were confirmed by Venereal Disease Research Laboratory (VDRL) non-treponemal test. VDRL non-reagent samples were confirmed by treponemal rapid immunochromatographic test. A rapid immunoblot assay confirmed seropositivity to HIV. Overall, anti-T. pallidum antibodies were observed in 29/116 (25.0%), anti-HCV antibodies in 4/116 (3.4%), and anti-HIV antibodies in 2/116 (1.7%) individuals, both co-infected with anti-T. pallidum antibodies. Associated risk factors for syphilis in homeless persons were being born or previously living in another city (p = 0.043) and becoming homeless due to family conflicts (p = 0.035). Besides homeless vulnerability, worldwide shortage of benzathine penicillin supply and increasing of syphilis testing access through rapid testing in primary health care services may have also impacted disease spreading at the time. The prevalence of syphilis found herein is the highest worldwide to date in this population.

Spinal toxoplasmosis in a young man with undiagnosed HIV infection

Spinal cord lesions are potentially devastating conditions leading to reduced mobility, loss of functional independence, and even ventilator dependence, dictated by the level of injury. Tissue diagnosis is paramount to differentiate between primary brain tumours such as ependymomas and glioblastomas, infarction, infection and demyelination. We present the case of a 30-year-old gentleman with subacute neck pain, nausea and evolving right upper limb weakness and paraesthesiae. MRI-spine demonstrated an intramedullary cervical spine mass with associated oedema, thought to represent an ependymoma. Open tissue biopsy revealed numerous bradyzoites on haematoxylin & eosin staining, subsequently confirmed by directed polymerase chain reaction testing as Toxoplasma gondii. Detailed immunological work-up led to a diagnosis of HIV infection, with detection of HIV antibodies and HIV-1 p24 antigen, an HIV-1 viraemia (log 6.33 copies/mL) and low CD4 count (16 cells/mL). Toxoplasmosis is the most common central nervous system infection in HIV patients not receiving appropriate prophylaxis.1 It may occur in up to 30% of such patients who are seropositive for Toxoplasma gondii,2 typically manifesting when CD4+ counts fall below 100 cells/mm3.3 This case highlights the importance of close collaboration between histopathology, microbiology and infectious diseases specialists in diagnosis of a spinal cord infection with associated HIV infection. 1.Porter SB, Sande MA. Toxoplasmosis of the central nervous system in the acquired immunodeficiency syndrome. N Engl J Med 1992; 327: 1643–8.2.Grant IH, Gold JW, Rosenblum M, et al. Toxoplasma gondii serology in HIV-infected patients: the development of central nervous system toxoplasmosis in AIDS. AIDS 1990; 4: 519–21.3.Kaplan JE, Benson C, Holmes KK, et al. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents. MMWR Recomm Rep 2009; 58: 1–207.

Screening of HIV and identifying risk factors among premedical students, Kafr El-Sheikh University, Egypt

Background and aim: HIV is a global public health problem. Many people in Egypt are afraid to get tested for HIV so the real situation remains unknown. The aim of this article was to determine HIV status and HIV related risk factor among Egyptian premedical students. Patients and Methods: A cross-sectional survey using a self-administered structured questionnaire was used to collect data to identify HIV related risk factor beside serosurvey to detect HIV antibodies among 737 from a total of 1123 pre medical students in Kafr El Sheikh University (KFU) who agreed to participate in the study. Results: The mean age of screened students was 18 ± 0.26 years. In total, 333 (45.2%) were males and 403 (54.8%) were females. Using HIV antibody testing; we did not find any positive HIV cases in our study. (7.5%) underwent any surgical procedure, (0.4%) received blood or blood product transfusions, and (0.1%) shared needle or syringe with others. While (42.8%) shared scissors, razors, and nail clippers with others and (57.3%) went ever to the dentist but none of them had any sexual relationships or HIV patient within the family. Conclusion: We detected no cases of HIV or risky behaviors among Egyptian premedical students.

HIV antibody screening and ways to improve it to address the problem of containing the spread of HIV infection

The purpose of the study is to determine the current trends in the development of the HIV epidemic process for individual subjects of the Ural Federal district (UFD) and the possibility of corrective measures to update the practice based on the results of screening tests for HIV antibodies.Materials and methods. The study used information from form 4 of the Federal statistical observation «Information on the results of blood tests for HIV antibodies» in the amount of 26,1 million studies for 2009–2018, information from 2,488 questionnaires from two biopsychological studies among commercial sex workers (CSR) and persons in prison. Research result. It was found that, despite the increase in the incidence of HIV infection in the period 2009–2018, the estimated Hurst indicator for the studied time period characterized the long-term dynamics of the incidence as antipersistent. Among MSM and patients with STIs, there is a marked tendency to increase the detection of HIV infection. Among commercial sex workers (CSR) and people in prison, the results of a sentinel bio-behavioral study found high detection of HIV antibodies against the background of risky sexual behavior.According to the indicators of the frequency of detection of antibodies to HIV in screening studies, the territories of the greatest potential risk of HIV infection were determined. In dynamics, there was an increase in the number of studies and the detection of HIV infection among those examined for clinical and epidemic indications (codes 113, 120) and stabilization of the detection of HIV infection among injecting drug users (code 102).Conclusion. In the period 2016–2018, the sexual route of infection became predominant among HIV-infected people. The greatest intensity of HIV infection was observed among such categories of the population covered by official statistics and who are representatives of groups with a predominant HIV infection, such as MSM and patients with STIs. At the same time, there was a decrease in HIV surveys among these populations with an increase in detection.The results of behavioral studies among DCS and persons in prison demonstrate high detection of HIV antibodies among them, as well as the presence of risky sexual behavior. Screening for HIV infection requires additional optimization.

A cross sectional study of lichen planus: It’s epidemiological, clinico-histopathogical and serological perspective

Lichen planus (LP) is a common papulosquamous skin disease with a prevalence 1-2% globally and 0.1 - 1.5% in Indian studies with many morphological presentations. LP is strongly associated with chronic HCV infection (3.1- 18.3% in different studies), while the association with other viral infections (Hepatitis B and HIV) is not that strong. There are only a few studies in Indian patients and the association reported is not uniform. Further studies will help to consolidate the association.1) To study the epidemiological and clinico- histopathological pattern in LP.2) To determine the serology and assess the possible association with HCV, HBsAg and HIV.140 patients of LP after histopathological confirmation were tested for detection of HCV antibodies, Hbs antigen and HIV antibodies by HCV-TRIDOT, HEPACARD and HIV –TRIDOT respectively. Statistical analysis was performed by SPSS software 20.0.Most common age group involved was 21-30 years. 75.6% of the patients presented with in 6 months of onset. Extremities and trunk were commonly involved. The most common clinical variants are classical LP(35%) and hypertrophic LP(31%). Mucosal involvement alone was observed in 9.3% patients . HBs Ag was positive in 4 cases , Anti HCV antibodies were positive in 3 cases and HIV was reactive in 3 cases.There is no significant relationship between LP and Hepatitis B, C and HIV virus. It may be suggested that viral serology (HBV, HCV, HIV) may not be necessary in routine screening for LP.

Facilitators and Barriers Associated with Uptake of HIV Self-Testing among Men Who Have Sex with Men in Chongqing, China: A Cross-Sectional Survey.

While studies on human immunodeficiency virus self-testing (HIVST) continue to accumulate after the World Health Organization’s recommendation of HIVST as an additional approach to HIV testing services in 2016, few studies have focused on men who have sex with men (MSM) in Chinese cities. A cross-sectional study was conducted to describe the HIVST status of MSM in Chongqing, China. MSM participants were recruited by random sampling, and qualified interviewers collected data, using confidential self-administered questionnaires. Blood specimens were collected for HIV antibody detection. The survey evaluated the uptake and accuracy of HIVST kits and identified factors that may be associated with HIVST. The proportion of HIVST uptake was 15.6%. The sensitivity and specificity of HIVST were 74.2% (95% confidence interval [CI] 66.6%–80.7%) and 99.0% (95% CI 96.9%–99.7%), respectively. The consistency between the HIVST kit and antibody detection results was 90.5% (95% CI 87.5%–93.0%), and the Kappa value was 0.777 (p < 0.001). The positive predictive value of self-testing kits is 80.9% and the negative predictive value is 17.7%. Having been tested ≥2 times in the last year, higher educational levels, and higher scores of basic HIV/AIDS knowledge facilitated higher uptake of HIVST. Self-reported existing barriers for HIVST uptake included older age, marital status, and having resided in Chongqing for more than two years.

Comparative multi-assay evaluation of Determine\u2122 HIV-1/2 Ag/Ab Combo rapid diagnostic tests in acute and chronic HIV infection

In resource-limited or point-of-care settings, rapid diagnostic tests (RDTs), that aim to simultaneously detect HIV antibodies and p24 capsid (p24CA) antigen with high sensitivity, can pose important alternatives to screen for early infections. We evaluated the performance of the antibody and antigen components of the old and novel version of the Determine™ HIV-1/2 Ag/Ab Combo RDTs in parallel to quantifications in a fourth-generation antigen/antibody immunoassay (4G-EIA), p24CA antigen immunoassay (p24CA-EIA), immunoblots, and nucleic acid quantification. We included plasma samples of acute, treatment-naïve HIV-1 infections (Fiebig stages I–VI, subtypes A1, B, C, F, CRF02_AG, CRF02_AE, URF) or chronic HIV-1 and HIV-2 infections. The tests’ antigen component was evaluated also for a panel of subtype B HIV-1 transmitted/founder (T/F) viruses, HIV-2 strains and HIV-2 primary isolates. Furthermore, we assessed the analytical sensitivity of the RDTs to detect p24CA using a highly purified HIV-1NL4-3 p24CA standard. We found that 77% of plasma samples from acutely infected, immunoblot-negative HIV-1 patients in Fiebig stages II–III were identified by the new RDT, while only 25% scored positive in the old RDT. Both RDTs reacted to all samples from chronically HIV-1-infected and acutely HIV-1-infected patients with positive immunoblots. All specimens from chronically infected HIV-2 patients scored positive in the new RDT. Of note, the sensitivity of the RDTs to detect recombinant p24CA from a subtype B virus ranged between 50 and 200 pg/mL, mirrored also by the detection of HIV-1 T/F viruses only at antigen concentrations tenfold higher than suggested by the manufacturer. The RTD failed to recognize any of the HIV-2 viruses tested. Our results indicate that the new version of the Determine™ HIV-1/2 Ag/Ab Combo displays an increased sensitivity to detect HIV-1 p24CA-positive, immunoblot-negative plasma samples compared to the precursor version. The sensitivity of 4G-EIA and p24CA-EIA to detect the major structural HIV antigen, and thus to diagnose acute infections prior to seroconversion, is still superior.

A 0.85% saline as alternative detection buffer for SD-bioline HIV rapid test in resource limited setting

Accuracy in the diagnosis is a key step to identify HIV infected individuals for appropriate management. Insufficient supply of manufacturer´s buffers in relation to the number of strips per kit has negative impact on patient´s results hence improper patient´s management. In resource limited settings, some laboratory staff use different substitute buffers which has never been validated on their reliability. This study aimed at comparing the performance of 0.85% saline and SD-Bioline manufacturer´s buffer in detection of HIV antibodies. A total of 220 whole blood specimens: 110 HIV positive specimens from patients attending care and treatment center (CTC) and 110 HIV negative specimens from blood donors were re-tested for HIV status using SD-Bioline HIV rapid test using manufacturer´s buffer and 0.85% saline separately. Data and laboratory results were recorded in Microsoft excel sheet followed by analysis using STATA version 13. For all tested samples, the level of agreement between 0.85% saline and manufacturer´s buffer was 98.64% (kappa=0.9727). The value of kappa indicates very good agreement between 0.85% saline and manufacturer´s buffer. In incidents where manufacturer´s buffer is not sufficient, 0.85% saline can give reliable results. Further studies to evaluate the suitable buffer for other rapid tests for HIV and other diseases are recommended especially in resource limited settings.

Evaluation and diagnostic usefulness of saliva for detection of HIV antibodies: A cross-sectional study.

Background:Use of saliva as a specimen for detection of antibodies to infectious agents has generated particular interest in AIDS research community since 1980s. HIV specific antibodies of immunoglobulin isotypes IgA, IgG, and IgM are readily found in salivary secretions.Aim and Objectives:In the present study, HIV specific antibodies were detected in saliva and serum samples of HIV patients by ELISA in confirmed HIV seropositive patients and efficacy of saliva was established in diagnosis of HIV.Methods:The 100 saliva and serum samples were collected from age and sex matched confirmed HIV seropositive subjects and 100 Healthy Controls without any infections. HIV antibodies were determined by enzyme-linked immunosorbent assay (ELISA) using Genscreen HIV 1/2 Kit.Results:The results were found to be 99% sensitive and 100% specific for saliva samples, while it was 100% sensitive and specific for serum samples.Conclusion:Saliva can be used as alternative to blood for detection of HIV antibodies as saliva collection is painless, non-invasive, inexpensive, simple, and rapid. Salivary antibody testing may provide better access to epidemic outbreaks, children, large populations, hard-to-reach risk groups and may thus play a major role in the surveillance and control of highly infectious diseases.

Nutritional, clinical and immunological status of children at HIV diagnosis in the continental region of Equatorial Guinea.

To evaluate the nutritional, clinical and immunological status of children at HIV diagnosis in the continental region of Equatorial Guinea. Children <18years diagnosed with HIV between 2009 and 2017 were included. Clinical, immunological and nutritional data were collected. Weight-for-height, weight-for-age and height-for-age Z-scores were calculated using WHO Child Growth Standards. The population was assessed in two equal periods (2009-2013 and 2014-2017) from the time of diagnosis. A total of 213 children were diagnosed with HIV (49.3% males), median age 3.8years (IQR: 1.5-8.2). A total of 121 cases (56.8%) were at WHO clinical stage III, and 53 (24.9%) were at WHO clinical stage IV. CDC immunological stage II was diagnosed in 51/130 (39.2%) and CDC stage III in 44/130 (33.8%). About 56.2% of children were underweight (weight-for-age <-2 SD); 20.1% moderately and 36.1% severely so. About 27.6% of children were wasted (weight-for-height <-2 SD); 11.9% moderately and 15.7% severely so. About 56.3% of children were stunted (height-for-age <-2 SD); 20.7% moderately and 35.6% severely so. The prevalence of wasting was higher in children ≤5years than in children >5years (36.4% vs. 19.1%, P=0.026). In the second period, the prevalence of moderate-severe immunodeficiency decreased (87.2% to 67.0%, P=0.018), without significant differences in the other nutritional or clinical data. Severe underweight was a risk factor for moderate-severe immunodeficiency (aOR: 4 [95% CI: 1.4-11.4], P=0.010). We highlight a high proportion of malnutrition at the time of HIV diagnosis in Guinea´s paediatric population. Early diagnosis of HIV infection is a priority, achievable by training Guinea´s physicians to suspect HIV early, introducing HIV molecular diagnostic techniques and ensuring intensive nutritional treatment.