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首页> 外文期刊>Journal of Clinical Microbiology >Lower-Sensitivity and Avidity Modifications of the Vitros Anti-HIV 1+2 Assay for Detection of Recent HIV Infections and Incidence Estimation
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Lower-Sensitivity and Avidity Modifications of the Vitros Anti-HIV 1+2 Assay for Detection of Recent HIV Infections and Incidence Estimation

机译：较低的灵敏度和亲和力修饰的体外抗HIV 1 + 2检测，用于检测最近的HIV感染和发病率估计

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Recent-infection testing assays/algorithms (RITAs) have been developed to exploit the titer and avidity of HIV antibody evolution following seroconversion for incidence estimation. The Vitros Anti-HIV 1+2 assay (Ortho-Clinical Diagnostics) was approved by the FDA to detect HIV-1 and HIV-2 infections. We developed a less-sensitive (LS) and an avidity-modified version of this assay to detect recent HIV infection. Seroconversion panels (80 subjects, 416 samples) were tested to calculate the mean duration of recent infection (MDR) for these assays. A panel from known long-term (2+ years) HIV-infected subjects on highly active antiretroviral therapy (HAART) (n = 134) and subjects with low CD4 counts (AIDS patients [n = 140]) was used to measure the false-recent rate (FRR) of the assays. Using a signal-to-cutoff ratio of 20 and the LS-Vitros assay gave a RITA MDR of 215 days (95% confidence interval [95% CI], ±65 days) and using an avidity index (AI) of 0.6 gave an MDR of 170 days (±44 days), while a combination of the two assays yielded a MDR of 146 days (±38.6) and an FRR of 8%. Misclassifying subjects with known long-term infection as recently infected occurred in 14% of AIDS patients and 29% (95% CI, 22, 38) of HAART subjects and 3% (95% CI, 0.8, 7.2) and 42% (95% CI, 33, 51), respectively, for the LS- and avidity-modified Vitros assays, with a misclassification rate of 15% (95% CI, 11, 20) overall using a dual-assay algorithm. Both modified Vitros assays can be used to estimate the length of time since seroconversion and in calculations for HIV incidence. Like other RITAs, they are subject to high FRR in subjects on HAART or with AIDS.
机译：已经开发了最近的感染测试测定法/算法（RITA），以利用血清转化后HIV抗体进化的效价和亲和力来进行发病率估计。 FDA批准了Vitros抗HIV 1 + 2测定法（Ortho-Clinical Diagnostics）来检测HIV-1和HIV-2感染。我们开发了一种灵敏度较低的（LS）和亲和力修饰的检测方法，用于检测最近的HIV感染。测试了血清转化小组（80名受试者，416个样品），以计算这些试验的近期感染平均持续时间（MDR）。来自已知长期（2年以上）HIV感染受试者的积极抗逆转录病毒疗法（HAART）（ n = 134）和CD4计数低的受试者（AIDS患者[ n = 140]）来衡量这些检测方法的错误率（FRR）。使用20的信噪比和LS-Vitros分析得出的RITA MDR为215天（95％置信区间[95％CI]，±65天），而亲和力指数（AI）为0.6则得出MDR为170天（±44天），而两种测定法的组合产生的MDR为146天（±38.6）和FRR为8％。 14％的AIDS患者和29％（95％CI，22、38）的HAART受试者以及3％（95％CI，0.8、7.2）和42％（95）的患者被误分类为已知近期感染为近期感染的受试者对于LS和亲和力改良的Vitros分析，分别为％CI，33、51），使用双重分析算法总体上误分类率为15％（95％CI，11、20）。两种改良的Vitros分析均可用于估计自血清转化以来的时间长度，并可以用于计算HIV发病率。与其他RITA一样，在接受HAART或艾滋病治疗的受试者中，它们的FRR较高。

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