Laboratory Diagnosis Of HIV Research Articles

Prevalence and factors associated with HIV and syphilis infection among children aged 0\u201336\xa0months in Kilimanjaro, Tanzania: a community-based cross-sectional study

BackgroundChildhood mortality is high in sub-Saharan Africa. Mother-to-child transmission (MTCT) of HIV and congenital syphilis are among significant causes. Dual elimination of these two infections is one of the international goals. Community-based studies on the burden of HIV and syphilis among children will contribute to fine-tuning the interventions to achieve the elimination goal. This study aims to describe the prevalence of HIV and syphilis among children aged 0–36 months and associated factors in northern Tanzania.MethodsThis was a community-based cross-sectional study, which was conducted in all the seven districts of Kilimanjaro region. Multistage sampling was used, and a total of 2452 children aged 0 to 36 months and their primary caretakers were enrolled. Interviews were conducted with the mother/caretaker, and dried blood samples were collected from the children and processed for laboratory diagnosis of HIV and syphilis. HIV ELISA was first performed on all the samples. Positive samples of children < 18 months were confirmed using PCR.ResultsThe prevalence of HIV among 2452 children aged 0–36 months was 1.7% (n = 42). There was a significant difference in the distribution of HIV by age of the child, maternal antenatal attendance, and breastfeeding history.The prevalence of syphilis was 0.4% (n = 10). Five of the children were more than 1 year old. All children with a positive test for syphilis were from Moshi rural district, and their mothers consumed alcohol. No child was co-infected with HIV and syphilis.ConclusionsThough the prevalence of the two infections was low, detecting syphilis in children suggests a missed opportunity in screening women during pregnancy. The region may be on track with the goal to achieve dual elimination of mother-to-child transmitted HIV and syphilis. However, efforts are needed to reduce missed opportunities for screening women for syphilis and HIV early in pregnancy and retesting at 3rd trimester/delivery. Strategies to improve testing for HIV-exposed children are needed.

Laboratory Diagnosis of HIV in the Outpatient Setting: One Hospital’s Perspective

Abstract Traditional methods for the diagnosis of human immunodeficiency virus types 1 and 2 (HIV-1, HIV-2) involve initial screening by an immunoassay followed by a specific method Western blot. However, Western blot is not sensitive compared to third-generation immunoassay, which detects both IgG and IgM antibodies against viral envelope proteins causing false-positive results. In addition, neither initial screening nor confirmatory Western blot is capable of detecting acute infection earlier in the disease process, when the virus is more adaptable and highly infectious. To detect both acute and established infection, Abbott Architect platform introduced a new fourth-generation antigen/antibody initial screening assay in 2013. Also, to reduce false-negative results from Western blot, an alternate method Bio-Rad multisport immunoassay was recommended by the Centers for Disease Control and Prevention (CDC) that has higher sensitivity and can differentiate HIV-1 and HIV-2 infections. In 2014, the CDC released updated recommendations for the laboratory diagnosis of HIV. The CDC diagnostic algorithm recommends an initial combination immunoassay that detects HIV-1 and HIV-2 antibodies, followed by supplemental testing with an immunoassay that differentiates HIV-1 and HIV-2 antibodies. Specimens reactive on the initial antigen/antibody immunoassay but nonreactive or indeterminate on the differentiation immunoassay should be followed by nucleic acid testing (NAT) for resolution of this discrepancy. The objective of our study was to review the effect of this updated testing algorithm on HIV testing results in the outpatient setting at Banner University Medical Center–Tucson in Tucson, Arizona. Our study utilized laboratory information system queries to retroactively review all outpatient HIV laboratory testing results obtained from 2013 to 2017. A total of 17,397 HIV-1/2 antigen/antibody immunoassays were performed during this time period. Of the initial antigen/antibody immunoassays, 1.1% were reactive (n = 183). Of these reactive tests, 85% were collected from individuals with established HIV infections (n = 155). HIV-1/HIV-2 antibody differentiation assays were performed on 175 patients, with 86% reactive (n = 150), 2.3% indeterminate (n = 4), and 12% nonreactive (n = 21). Acute HIV-1 infections (antigen/antibody immunoassay reactive, antibody differentiation immunoassay nonreactive or indeterminate, and NAT positive) accounted for 2.7% of patients with reactive initial antigen/antibody immunoassays and 0.03% of all patients screened for HIV infection with the initial antigen/antibody immunoassay (n = 5). Viral loads in the patients with acute HIV-1 infection ranged from 173,000 to &gt;10,000,000 copies/mL. No HIV-2 infections were identified in our patient population. Given that the previous CDC testing algorithm for HIV-1 failed to identify acute HIV-1 infections, our data, which confirm the ability of the current CDC algorithm to detect HIV-1 infections, represent important information for infectious disease practitioners, public health officials, and laboratory directors.

SEROPREVALENCE OF HIV AND HBsAg AMONGST BLOOD DONORS IN A TERTIARY CARE HOSPITAL, CHHATTISGARH.

INTRODUCTION: India being the second highly populated nation in the world. HIV/AIDS has acquired pandemic proportion in the world. Estimate by WHO for current infection rate in Asia. India has the third largest HIV epidemic in the world. HIV prevalence in the age group 15-49 yrs was an estimate of 0.2%. India has been classified as an intermediate in the Hepatitis B Virus (HBV) endemic (HBsAg carriage 2-7%) zone with the second largest global pool of chronic HBV infections. Safety assessment of the blood supply, the quality of screening measures and the risk of transfusion transmitted infectious diseases (TTIs) in any country can be estimated by scrutinizing the files of blood donors. After the introduction of the blood banks and improved storage facilities, it became more extensively used. Blood is one of the major sources of TTIs like hepatitis B, hepatitis C, HIV, syphilis, and many other blood borne diseases. Disclosure of these threats brought a dramatic change in attitude of physicians and patients about blood transfusion. The objective of this study is to determine the seroprevalence of transfusion transmitted infections amidst voluntary blood donors at a rural tertiary healthcare teaching hospital in Chhattisgarh.&#x0D; MATERIAL AND METHODS: This retrospective study was carried out in Chandulal Chandrakar Memorial Medical College, Kachandur, Durg. Blood donors were volunteers, or and commercial donors who donated the blood and paid by patients, their families, or friends to replace blood used or expected to be used for patients from the blood bank of the hospital. After proper donation of blood routine screening of blood was carried out according to standard protocol. Laboratory diagnosis of HIV 1 and HIV 2 was carried out by ELISA test. Hepatitis B surface antigen was screened by using ELISA. RESULTS: A total of 1915 consecutive blood donors’ sera were screened at Chandulal Chandrakar Memorial Medical College, blood bank during study period. Of these 1914 were male and 1 female. The mean age of patients was found to be 29.34 years with standard deviation (SD) of 11.65 Years. Among all blood donors in present study, 759(39.63%) were first time donors and 1156(60.37%) were repeated donors. 1 patient was HIV positive in first donation group while 3 (75%) were positive in repeat donation group. 7 (38.9%) were HBsAg positive in in first donation group while 11(61.1%) were positive in repeat donation group. Two patients in first donation group had dual infection of HIV and HBsAg.&#x0D; CONCLUSION: Seropositivity was high in repeated donors as compared to first time donors. The incidence of HIV is observed to be 0.2% and that of HBsAg is 0.94%. Strict selection of blood donors should be done to avoid transfusion-transmissible infections during the window period.

Introduction to 2013 Journal of Clinical Virology Supplement on HIV Testing Algorithms

Presentations at the 2012 HIV Diagnostics Conference http://www.hivtestingconfrence.org) documented significant rogress with validation and implementation of a new algorithm or the laboratory diagnosis of HIV. The algorithm proposed in 010 by the Centers for Disease Control and Prevention (CDC, tlanta, GA) and the Association of Public Health Laboratories APHL, Silver Spring, MD), begins with 4th generation screening ests that detect HIV p24 antigen in addition to HIV-1 and HIV-2 ntibodies, followed by a supplemental antibody assay to validate he presence of HIV-1 or HIV-2 antibodies and, if necessary, nucleic cid testing to identify HIV in patients who have not yet developed ntibodies. An increasing body of evidence now demonstrates the benets of prompt antiretroviral therapy for persons with acute and arly HIV infection. Prompt initiation of effective treatment helps reserve immune function, reduces the risk of onward viral transission, and may limit the size of the reservoir of latent virus that s established early after infection. These observations give rise to autious hope for more effective use of antiretroviral therapy to ork toward a functional cure. The challenge, until now, has been to evelop effective and economical techniques to identify HIV infecion during its earliest stages. With the new diagnostic algorithm, his is now practical.

Utility of clinical parameters to identify HIV infection in infants below ten weeks of age in South Africa: a prospective cohort study

BackgroundAs HIV-infected infants have high mortality, the World Health Organization now recommends initiating antiretroviral therapy as early as possible in the first year of life. However, in many settings, laboratory diagnosis of HIV in infants is not readily available. We aimed to develop a clinical algorithm for HIV presumptive diagnosis in infants < 10 weeks old using screening data from the Children with HIV Early Antiretroviral therapy (CHER) study in South Africa.HIV-infected and HIV-uninfected exposed infants < 10 weeks of age were identified through Vertical Transmission Prevention programs. Clinical and laboratory data were systematically recorded, groups were compared using Kruskal-Wallis, analysis of variance (ANOVA), and Fisher's exact tests. Receiver Operating Characteristic (ROC) curves were compiled using combinations of clinical findings.Results417 HIV-infected and 125 HIV-exposed, uninfected infants, median age 46 days (IQR 38-55), were included. The median CD4 percentage in HIV-infected infants was 34 (IQR 28-41)%. HIV-infected infants had lower weight-for-age, more lymphadenopathy, oral thrush, and hepatomegaly than exposed uninfected infants (Adjusted Odds Ratio 0.51, 8.8, 5.6 and 23.5 respectively; p < 0.001 for all). Sensitivity of individual signs was low (< 20%) but specificity high (98-100%). If any one of oral thrush, hepatomegaly, splenomegaly, lymphadenopathy, diaper dermatitis, weight < 50th centile are present, sensitivity for HIV infection amongst HIV-exposed infants was 86%. These algorithms performed similarly when used to predict severe immune suppression.ConclusionsA combination of physical findings is helpful in identifying infants most likely to be HIV-infected. This may inform management algorithms and provide guidance for focused laboratory testing in some settings, and should be further validated in these settings and elsewhere.

Laboratory diagnosis of HIV

Laboratory diagnosis of HIV

Laboratory diagnosis of HIV

Laboratory diagnosis of HIV

How Do We Interpret the HIV Incidence Estimates Reported by Kumwenda et al?

Kumwenda et al have reported on HIV incidence estimates from a multisite study conducted in Lilongwe and Blantyre (Malawi) and Harare (Zimbabwe). Several issues deserve comment: 1) the HIV incidence estimates 2) the reasons behind high incidence of HIV despite a declining sexually transmitted infection (STI) prevalence 3) laboratory diagnosis of HIV in the study and 4) interpretation of the findings. The authors report of HIV incidence rates of 4.9 and 4.3 per 100 woman-years and compare these with previous estimates as reported by Taha et al (Malawi) and Mbizvo et al (Zimbabwe) and argue that HIV incidence has not changed in these communities. The problem with this comparison is that the current study had a different population group from the earlier studies. Although family planning and postnatal clinic attendees were recruited by Kumwenda et al the previous studies used antenatal and postnatal a population that may not be comparable when other family planning attendees (nonpostnatal) are used. Also in the current study the women recruited received 5 intensive counseling and condom promotion session thus making them less representative of regular clinic attendees or even the general population. If the populations used previously are different from the current study it may be misleading to draw conclusions of a trend for populations that may not comparable. (excerpt)

Predictors of AIDS knowledge, condom use and high-risk sexual behaviour among women in Dar-es-Salaam, Tanzania.

Reducing the number of sex partners and using condoms are the major means for individuals to protect themselves from STDs and AIDS in sub-Saharan Africa. To identify predictors of having only one sex partner in the last year and to assess knowledge and use of condoms among women of reproductive age in Dar-es-Salaam, Tanzania, we interviewed 2285 women at 3 representative family planning clinics between February 1991 and June 1992. After interview, blood and genital specimens were collected for laboratory diagnosis of HIV and other sexually transmitted diseases (STDs). Although knowledge of sexual transmission of AIDS was very high, less than a half of the respondents (42.8%) mentioned use of condoms as an AIDS preventive measure. Younger and more educated women were more likely to mention use of condoms for AIDS prevention, however only 4.6% of women interviewed were regular users of condoms, while 19.8% were occasional users. The majority of women who had never used a condom (57.5%) reported not using condoms because 'men did not like them'. Condom use was positively associated with increasing level of education and increasing number of sexual partners. 14.8% of women reported having more than one sex partner in the last year; this behaviour was more likely among cohabiting women (increased by 210%); HIV-positives (increased by 120%); and among women with STDs (increased by 50%).(ABSTRACT TRUNCATED AT 250 WORDS)