Performance of a Modified In-House HIV-1 Avidity Assay among a Cohort of Newly Diagnosed HIV-1 Infected Individuals and the Effect of ART on the Maturation of HIV-1 Specific Antibodies

Author(s): Diviya Alex, Tennison Inba Raj Williams, Jaiprasath Sachithanandham, Swaminathan Prasannakumar, John Paul Demosthenes, Veena Vadhini Ramalingam, Punitha John Victor, Priscilla Rupali, Gnanadurai John Fletcher, Rajesh Kannangai*

Journal Name: Current HIV Research
HIV and Viral Immune Diseases

Volume 17 , Issue 2 , 2019


DOI : 10.2174/1570162X17666190712125606

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Graphical Abstract:


Abstract:

Background: Viral kinetics impact humoral immune response to HIV; antibody avidity testing helps distinguish recent (<6 months) and long-term HIV infection. This study aims to determine the frequency of recent HIV-1 infection among clients attending ICTC (Integrated Counselling and Testing Centre) using a commercial EIA, to correlate it with a modified in-house avidity assay and to study the impact of ART on anti-HIV-1 antibody maturation.

Methods: Commercial LAg Avidity EIA was used to detect antibody avidity among 117 treatment naïve HIV-1 infected individuals. A second-generation HIV ELISA was modified for in-house antibody avidity testing and cutoff was set based on Receiver Operating Characteristic (ROC) analysis. Archived paired samples from 25 HIV-1 infected individuals before ART and after successful ART; samples from 7 individuals responding to ART and during virological failure were also tested by LAg Avidity EIA.

Results: Six individuals (5.1%) were identified as recently infected by a combination of LAg avidity assay and HIV-1 viral load testing. The modified in-house avidity assay demonstrated sensitivity and specificity of 100% and 98.2%, respectively, at AI=0.69 by ROC analysis. Median ODn values of individuals when responding to ART were significantly lower than pre-ART [4.136 (IQR 3.437– 4.827) vs 4.455 (IQR 3.748–5.120), p=0.006] whereas ODn values were higher during virological failure [4.260 (IQR 3.665 – 4.515) vs 2.868 (IQR 2.247 – 3.921), p=0.16].

Conclusion: This modified in-house antibody avidity assay is an inexpensive method to detect recent HIV-1 infection. ART demonstrated significant effect on HIV-1 antibody avidity owing to changes in viral kinetics.

Keywords: Avidity assay, LAg avidity assay, HIV, recent infection, ART, India.

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VOLUME: 17
ISSUE: 2
Year: 2019
Published on: 12 July, 2019
Page: [134 - 145]
Pages: 12
DOI: 10.2174/1570162X17666190712125606
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