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Lemée V, Gréaume S, Gautier J, Dzamitika SA, Coignard C, Jortani SA, Grillet B, Badawi M, Plantier JC. Performance evaluation of the new Access HIV Ag/Ab combo assay on the DxI 9000 Access Immunoassay Analyzer. J Clin Virol 2024; 174:105712. [PMID: 39047323 DOI: 10.1016/j.jcv.2024.105712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 07/03/2024] [Accepted: 07/05/2024] [Indexed: 07/27/2024]
Abstract
Fourth-generation HIV immunoassays have been developed to reduce the window period of detection during seroconversion period, allowing for the detection of early and established infections. The aim of this work was to evaluate a newly developed assay, Access HIV Ag/Ab combo on the novel high throughput DxI 9000 Access Immunoassay Analyzer (Beckman Coulter, Inc.). The assay allows for simultaneous qualitative detection and differentiation of HIV-1 p24 antigen and HIV-1/2 antibodies. Assay performance was compared to two gold standard assays, the Abbott Architect HIV Ag/Ab Combo and Roche Elecsys HIV Duo, and assessed in a multicenter study, using a wide panel of samples (n > 9000, clinical samples and viral lysates) representative of genetic diversity for both antibodies and antigens, early phases of infection, negative, and cross-reacting samples. The clinical sensitivity was 100 % for clinical samples as well as for viral lysates. Data on viral lysates and early detection on seroconversion panels showed a better result with the Access assay. Analytical sensitivity showed a limit of p24 detection determined around 0.2 IU/mL. The overall specificity was 99.91 %, and no interference was found using the potentially cross-reactive samples. In conclusion, the Access HIV Ag/Ab combo assay demonstrated its ability for accurate diagnosis of chronic as well as primary HIV infections on the DxI 9000 Analyzer, despite the high level of genetic diversity of these viruses.
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Affiliation(s)
- V Lemée
- CHU Rouen, Department of Virology, National Reference Center of HIV, F-76000 Rouen, France; Univ Rouen Normandie, Univ de Caen, INSERM, DYNAMICURE UMR 1311, CHU Rouen, Department of Virology, National Reference Center of HIV, F-76000 Rouen, France
| | - S Gréaume
- Etablissement Français du Sang (EFS) Hauts-de-France - Normandie (HFNO), Bois Guillaume, France
| | | | | | - C Coignard
- Eurofins Biomnis, Ivry-sur-Seine, France
| | - S A Jortani
- Kentucky Clinical Trials Laboratory (KCTL), Louisville, KY, USA; University of Louisville School of Medicine, Louisville, KY, USA
| | - B Grillet
- Beckman Coulter Immunotech, Marseille, France
| | - M Badawi
- Beckman Coulter Immunotech, Marseille, France
| | - J-C Plantier
- CHU Rouen, Department of Virology, National Reference Center of HIV, F-76000 Rouen, France; Univ Rouen Normandie, Univ de Caen, INSERM, DYNAMICURE UMR 1311, CHU Rouen, Department of Virology, National Reference Center of HIV, F-76000 Rouen, France.
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Alessandri-Gradt E, Moisan A, Plantier JC. HIV-1 Non-Group M Strains and ART. Viruses 2023; 15:v15030780. [PMID: 36992488 PMCID: PMC10058373 DOI: 10.3390/v15030780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
To eliminate HIV infection, there are several elements to take into account to limit transmission and break viral replication, such as epidemiological, preventive or therapeutic management. The UNAIDS goals of screening, treatment and efficacy should allow for this elimination if properly followed. For some infections, the difficulty is linked to the strong genetic divergence of the viruses, which can impact the virological and therapeutic management of patients. To completely eliminate HIV by 2030, we must therefore also be able to act on these atypical variants (HIV-1 non-group M) which are distinct from the group M pandemic viruses. While this diversity has had an impact on the efficacy of antiretroviral treatment in the past, recent data show that there is real hope of eliminating these forms, while maintaining vigilance and constant surveillance, so as not to allow more divergent and resistant forms to emerge. The aim of this work is therefore to share an update on the current knowledge on epidemiology, diagnosis and antiretroviral agent efficacy of HIV-1 non-M variants.
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Affiliation(s)
- Elodie Alessandri-Gradt
- Univ Rouen Normandie, UNICAEN, INSERM, DYNAMICURE UMR 1311, and CHU Rouen, Department of Virology, National Reference Center of HIV, F-76000 Rouen, France
| | - Alice Moisan
- Univ Rouen Normandie, UNICAEN, INSERM, DYNAMICURE UMR 1311, and CHU Rouen, Department of Virology, National Reference Center of HIV, F-76000 Rouen, France
| | - Jean-Christophe Plantier
- Univ Rouen Normandie, UNICAEN, INSERM, DYNAMICURE UMR 1311, and CHU Rouen, Department of Virology, National Reference Center of HIV, F-76000 Rouen, France
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Biyang YVS, Parkouda S, Bivigou-Mboumba B, Iroungou BA, Ondeme AM, Bisseye C. Evaluation of HIV-1 rapid diagnostic tests in the context of viral genetic diversity in Libreville (Gabon). Pan Afr Med J 2022; 42:194. [PMID: 36212939 PMCID: PMC9508364 DOI: 10.11604/pamj.2022.42.194.35035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/21/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction in order to promote rapid care of HIV-positive people and to reduce the human immunodeficiency virus (HIV) transmission in Gabon, the national screening algorithm is essentially based on rapid diagnostic tests (RDTs). However, most of these RDTs are not evaluated. Their sensitivities and specificities remain unknown locally. The aim of this study was to determine the diagnostic performance of 3 RDTs used for HIV-1> screening in Gabon. Methods of the one hundred and sixteen (116) samples tested, 60 plasmas were HIV-1 positive with known genotypes and viral loads; 51 sera were HIV-1 negative while 5 had an undetermined serological status. All the samples were tested by quantitative RT-PCR (Gold standard) and by the following RDTs: Vikia, Alere Combo and Alere Determine. The sensitivities and specificities of the different RDTs were calculated using Epi Info version 6.04dfr. The level of agreement between tests was determined by Cohen´s Kappa test. Results the three RDTs´ sensitivity according to HIV-1/M subtypes was 100% (95% CI: 92.6-100) while their specificities ranged from 94.6% (95% CI: 84.2-98.6) for the Vikia test to 96.4% (95% CI: 86.6-99.4) for the Alere Combo and Alere Determine tests, respectively. The concordances between the three RDTs were excellent with kappa values ranging from 0.931 (95% CI: 0.864-0.977) to 0.948 (95% CI: 0.890-1.00). Conclusion the three RDTs showed a maximum sensitivity of 100% and specificities ranging from 94.6% to 96.4%. The specificities obtained with these RDTs are lower than those recommended by the WHO for their inclusion in an HIV-1 screening algorithm.
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Affiliation(s)
- Yann Vital Sima Biyang
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku, BP 943, Franceville, Gabon
| | - Soulemane Parkouda
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku, BP 943, Franceville, Gabon,,Centre Hospitalier Régional Georges RAWIRI (CHRGR), Lambaréné, Gabon
| | - Berthold Bivigou-Mboumba
- Unité Mixte de Recherches sur le VIH et les Maladies Infectieuses Associées (UMR, MIA), Hôpital d´Instruction des Armées Omar BONGO ONDIMBA, Libreville, Gabon,,Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Berthe Amélie Iroungou
- Unité Mixte de Recherches sur le VIH et les Maladies Infectieuses Associées (UMR, MIA), Hôpital d´Instruction des Armées Omar BONGO ONDIMBA, Libreville, Gabon
| | - Augustin Mouinga Ondeme
- Unité Mixte de Recherches sur le VIH et les Maladies Infectieuses Associées (UMR, MIA), Hôpital d´Instruction des Armées Omar BONGO ONDIMBA, Libreville, Gabon,,Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Cyrille Bisseye
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku, BP 943, Franceville, Gabon,,Corresponding author: Cyrille Bisseye, Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku, BP 943, Franceville, Gabon.
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Oluniyi PE, Ajogbasile FV, Zhou S, Fred-Akintunwa I, Polyak CS, Ake JA, Tovanabutra S, Iroezindu M, Rolland M, Happi CT. HIV-1 drug resistance and genetic diversity in a cohort of people with HIV-1 in Nigeria. AIDS 2022; 36:137-146. [PMID: 34628443 PMCID: PMC8654252 DOI: 10.1097/qad.0000000000003098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This study was designed to provide information on the genetic diversity of HIV-1 and drug resistance mutations in Nigeria, as there is limited understanding of variants circulating in the country. METHODS We used an advanced next-generation sequencing platform, Primer ID, to: investigate the presence of high and low abundance drug resistance mutations; characterize preexisting Integrase Strand Transfer Inhibitor (INSTI) mutations in antiretroviral therapy (ART)-experienced but dolutegravir-naive individuals; detect recent HIV-1 infections and characterize subtype diversity from a cohort of people with HIV-1 (PWH). RESULTS HIV-1 subtype analysis revealed the predominance of CRF02_AG and subtype G in our study population. At detection sensitivity of 30% abundance, drug resistance mutations (DRMs) were identified in 3% of samples. At a sensitivity level of 10%, DRMs were identified in 27.3% of samples. We did not detect any major INSTI mutation associated with dolutegravir-resistance. Only one recent infection was detected in our study population. CONCLUSION Our study suggests that dolutegravir-containing antiretroviral regimens will be effective in Nigeria. Our study also further emphasizes the high genetic diversity of HIV-1 in Nigeria and that CRF02_AG and subtype G are the dominant circulating forms of HIV-1 in Nigeria. These two circulating forms of the virus are largely driving the epidemic in the country.
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Affiliation(s)
- Paul E. Oluniyi
- Department of Biological Sciences, Faculty of Natural Sciences
- African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University, Ede, Osun State, Nigeria
| | - Fehintola V. Ajogbasile
- Department of Biological Sciences, Faculty of Natural Sciences
- African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University, Ede, Osun State, Nigeria
| | - Shuntai Zhou
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Iyanuoluwa Fred-Akintunwa
- African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University, Ede, Osun State, Nigeria
| | - Christina S. Polyak
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Silver Spring, Maryland, USA
| | - Julie A. Ake
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research
| | - Sodsai Tovanabutra
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Silver Spring, Maryland, USA
| | - Michael Iroezindu
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research
- HJF Medical Research International, Abuja, Nigeria
| | - Morgane Rolland
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Silver Spring, Maryland, USA
| | - Christian T. Happi
- Department of Biological Sciences, Faculty of Natural Sciences
- African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University, Ede, Osun State, Nigeria
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Mikasi SG, Isaacs D, Chitongo R, Ikomey GM, Jacobs GB, Cloete R. Interaction analysis of statistically enriched mutations identified in Cameroon recombinant subtype CRF02_AG that can influence the development of Dolutegravir drug resistance mutations. BMC Infect Dis 2021; 21:379. [PMID: 33892628 PMCID: PMC8063366 DOI: 10.1186/s12879-021-06059-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 04/08/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The Integrase (IN) strand transfer inhibitor (INSTI), Dolutegravir (DTG), has been given the green light to form part of first-line combination antiretroviral therapy (cART) by the World Health Organization (WHO). DTG containing regimens have shown a high genetic barrier against HIV-1 isolates carrying specific resistance mutations when compared with other class of regimens. METHODS We evaluated the HIV-1 CRF02_AG IN gene sequences from Cameroon for the presence of resistance-associated mutations (RAMs) against INSTIs and naturally occurring polymorphisms (NOPs), using study sequences (n = 20) and (n = 287) sequences data derived from HIV Los Alamos National Laboratory database. The possible impact of NOPs on protein structure caused by HIV-1 CRF02_AG variations was addressed within the context of a 3D model of the HIV-1 IN complex and interaction analysis was performed using PyMol to validate DTG binding to the Wild type and seven mutant structures. RESULTS We observed 12.8% (37/287) sequences to contain RAMs, with only 1.0% (3/287) of the sequences having major INSTI RAMs: T66A, Q148H, R263K and N155H. Of these,11.8% (34/287) of the sequences contained five different IN accessory mutations; namely Q95K, T97A, G149A, E157Q and D232N. NOPs occurred at a frequency of 66% on the central core domain (CCD) position, 44% on the C-terminal domain (CTD) position and 35% of the N-terminal domain (NTD) position. The interaction analysis revealed that DTG bound to DNA, 2MG ions and DDE motif residues for T66A, T97A, Q148H, N155H and R263K comparable to the WT structure. Except for accessory mutant structure E157Q, only one MG contact was made with DTG, while DTG had no MG ion contacts and no DDE motif residue contacts for structure D232N. CONCLUSIONS Our analysis indicated that all RAM's that resulted in a change in the number of interactions with encompassing residues does not affect DTG binding, while accessory mutations E157Q and D232N could affect DTG binding leading to possible DTG resistance. However, further experimental validation is required to validate the in silico findings of our study.
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Affiliation(s)
- Sello Given Mikasi
- Division of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Darren Isaacs
- South African Medical Research Council Bioinformatics Unit, South African National Bioinformatics Institute, University of the Western Cape, Robert Sobukwe Rd, Bellville, P.O. Box X17, Cape Town, 7535, South Africa
| | - Rumbidzai Chitongo
- South African Medical Research Council Bioinformatics Unit, South African National Bioinformatics Institute, University of the Western Cape, Robert Sobukwe Rd, Bellville, P.O. Box X17, Cape Town, 7535, South Africa
| | - George Mondide Ikomey
- Centre for the Study and Control of Communicable Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Graeme Brendon Jacobs
- Division of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Ruben Cloete
- South African Medical Research Council Bioinformatics Unit, South African National Bioinformatics Institute, University of the Western Cape, Robert Sobukwe Rd, Bellville, P.O. Box X17, Cape Town, 7535, South Africa.
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Udeze AO, Olaleye DO, Odaibo GN. Phylogeny of partial gag, pol and env genes show predominance of HIV-1G and CRF02_AG with emerging recombinants in south-eastern Nigeria. Heliyon 2020; 6:e04310. [PMID: 32775738 PMCID: PMC7403892 DOI: 10.1016/j.heliyon.2020.e04310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/06/2020] [Accepted: 06/22/2020] [Indexed: 12/20/2022] Open
Abstract
Human Immunodeficiency Virus is characterized by high degree of genetic diversity with marked differences in its geographic distribution even within a country. This study was designed to identify the strains of HIV-1 circulating among infected individuals in southeastern parts of Nigeria. Genomic DNA was extracted from blood samples of 30 HIV-1 infected individuals from Anambra, Delta and Imo states of southeastern Nigeria. Portions of the genome corresponding to entire p24 gag, entire protease and C2-V3 env genes were amplified by nested PCR, sequenced using Sanger's method and phylogenetically analysed. Out of the 30 samples sequenced, 17, 28 and 14 readable sequences were obtained for gag, pol and env regions respectively. The most prevalent subtypes were CRF02_AG (41.2% in gag, 57.1% in pol protease and 50.0% in env) and G (29.4% in gag, 35.7% in pol protease and 35.7% in env). Other subtypes identified include A (17.7% in gag, 7.1% in env) and J (7.1% in env). Also 2 sequences each in gag (11.8%) and pol protease (7.1%) regions were unclassified but preliminary analysis showed they are recombinants. Furthermore, 71.4% of the isolates with sequences in the 3 regions and 26.7% of those with sequences in 2 genomic regions were recombinant forms. CRF02_AG and subtype G are the predominant HIV-1 strains circulating among infected individuals in southeastern Nigeria. Preliminary analysis results of unclassified sequences suggest that they are new recombinants.
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Affiliation(s)
- Augustine O Udeze
- Department of Virology, College of Medicine, University College Hospital, Ibadan, Nigeria.,Virology Unit, Department of Microbiology, University of Ilorin, P.M.B 1515, Ilorin, Nigeria
| | - David O Olaleye
- Department of Virology, College of Medicine, University College Hospital, Ibadan, Nigeria
| | - Georgina N Odaibo
- Department of Virology, College of Medicine, University College Hospital, Ibadan, Nigeria
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DeMarco ML, Nguyen Q, Fok A, Hsiung GR, van der Gugten JG. An automated clinical mass spectrometric method for identification and quantification of variant and wild-type amyloid-β 1-40 and 1-42 peptides in CSF. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12036. [PMID: 32617385 PMCID: PMC7327131 DOI: 10.1002/dad2.12036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION We developed an automated liquid chromatography-tandem mass spectrometry high performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) method for multiplex quantification of wild-type (wt) amyloid β (Aβ) peptides 1-40 (Aβ40) and 1-42 (Aβ42) and detection of variant Aβ peptides in cerebrospinal fluid. METHODS The multiplex Aβ HPLC-MS/MS assay was validated in a clinically accredited laboratory following regulatory guidelines, with Aβ42 calibration assigned to the ERM/IFCC certified reference material; sequence variants were additionally multiplexed into the method. RESULTS Sample preparation was fully automated on a liquid handler. The assay quantified wt-Aβ42 and wt-Aβ40 and detected sequence variants, when present, within the Aβ42 sequence. DISCUSSION Extension of the HPLC-MS/MS approach for quantification of wt-Aβ42 and wt-Aβ40 to include known sequence variants increases analytical accuracy of the mass spectrometric approach and enables identification of cases of autosomal dominant Alzheimer's disease. Development of an automated workflow and selection of appropriate instrumentation enabled deployment of this method in routine clinical testing.
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Affiliation(s)
- Mari L. DeMarco
- Department of Pathology and Laboratory MedicineProvidence Health CareVancouverBritish ColumbiaCanada
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Quyen Nguyen
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Alice Fok
- Division of NeurologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - J. Grace van der Gugten
- Department of Pathology and Laboratory MedicineProvidence Health CareVancouverBritish ColumbiaCanada
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Berger A, Muenchhoff M, Hourfar K, Kortenbusch M, Ambiel I, Stegmann L, Heim A, Sarrazin C, Ehret R, Daniel V, Wasner M, Plantier JC, Eberle J, Gürtler L, Haberl AE, Stürmer M, Keppler OT. Severe underquantification of HIV-1 group O isolates by major commercial PCR-based assays. Clin Microbiol Infect 2020; 26:1688.e1-1688.e7. [PMID: 32184172 DOI: 10.1016/j.cmi.2020.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 03/02/2020] [Accepted: 03/05/2020] [Indexed: 11/16/2022]
Abstract
HIV-1 diversity poses major challenges to viral load assays because genetic polymorphisms can impede nucleic acid detection. In addition to the on-going viral diversification within the HIV-1 group M pandemic, HIV-1 genetic diversity is further increased by non-group M infections, such as HIV-1 groups O (HIV-1-O), N and P. We here conducted a systematic evaluation of commercially available PCR assays to detect HIV-1-O isolates. We collected 25 primary HIV-1-O isolates covering all genetic clusters within HIV-1-O. Subsequently, this panel of isolates was tested on eight commercially available quantitative and five qualitative HIV-1 PCR-based assays in serial dilutions. Sequence analyses were performed for severe cases of underquantification or lack of detection. We observed differences between the assays in quantification that depended on the HIV-1-O isolate's subgroup. All three tested HIV-1-O subgroup IV isolates were underquantified by the Roche CAP/CTM >800-fold compared to the Abbott RealTime assay. In contrast, the latter assay underquantified several subgroup I isolates >200-fold. Notably, the Xpert HIV-1 Viral Load test from Cepheid failed to detect two of the HIV-1-O isolates, whereas the Roche Cobas 8800 assay readily detected all isolates. Comparative sequence analyses identified polymorphisms in the HIV-1-O long-terminal repeat and integrase genes that likely underlie inadequate nucleic acid amplification. Potential viral load underquantification should be considered in therapeutic monitoring of HIV-1-O-infected patients. Pre-clinical assessments of HIV-1 diagnostic assays could be harmonized by establishing improved and internationally standardized panels of HIV-1 isolates that cover the dynamic diversity of circulating HIV-1 strains.
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Affiliation(s)
- A Berger
- Institute of Medical Virology, University Hospital, Germany
| | - M Muenchhoff
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Germany; German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - K Hourfar
- German Red Cross, Baden-Wuerttemberg-Hessen, Institute of Transfusion Medicine and Immunochemotherapy, Germany
| | - M Kortenbusch
- Institute of Medical Virology, University Hospital, Germany
| | - I Ambiel
- Institute of Medical Virology, University Hospital, Germany
| | - L Stegmann
- Institute of Medical Virology, University Hospital, Germany
| | - A Heim
- Institute for Virology, Hannover Medical School, Hannover, Germany
| | - C Sarrazin
- Department of Internal Medicine 1, University Hospital, Germany
| | - R Ehret
- MVZmib AG, Medical Center for Infectious Diseases, Berlin, Germany
| | - V Daniel
- Transplantation Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - M Wasner
- KH Labor GmbH, AMEOS Group, Bernburg, Germany
| | - J-C Plantier
- Normandy University, UNIROUEN, GRAM EA2656, Rouen University Hospital, Laboratory of Virology Associated with the National Reference Centre for HIV, Rouen, France
| | - J Eberle
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Germany
| | - L Gürtler
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Germany
| | - A E Haberl
- Internal Medicine II, Department for Infectious Diseases, University Hospital, Goethe University, Germany
| | - M Stürmer
- Institut für Medizinische Diagnostik, Subunit Laboratory Frankfurt, Frankfurt, Germany
| | - O T Keppler
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Germany; German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany.
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Unal G, Alessandri-Gradt E, Leoz M, Pavie J, Lefèvre C, Panjo H, Charpentier C, Descamps D, Barin F, Simon F, Meyer L, Plantier JC. Human Immunodeficiency Virus Type 1 Group O Infection in France: Clinical Features and Immunovirological Response to Antiretrovirals. Clin Infect Dis 2019; 66:1785-1793. [PMID: 29272369 DOI: 10.1093/cid/cix1087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 12/19/2017] [Indexed: 11/13/2022] Open
Abstract
Background To obtain reliable clinical data of human immunodeficiency virus type 1 group O (HIV-1/O) infection, and immunovirological responses to combination antiretroviral therapy (cART), in a large series of 101 patients. Methods Piecewise linear models were used to estimate CD4 count before and after cART initiation. Kaplan-Meier survival curves were used to estimate time to reach clinical stage C before antiretroviral therapy (ART) and to analyze time to achieve a plasma viral load (pVL) <40 copies/mL following cART initiation. Immunovirological response was assessed at the most recent visit in patients on active follow-up. Results Data showed a 16.6% cumulative probability of reaching stage C within 5 years following diagnosis, and a mean CD4 decrease of -30.5 cells/μL/year. cART initiation in ART-naive patients led to a mean CD4 gain of 147 cells/μL after 12 months, and to a median pVL of <40 copies/mL after 3.8 months for 89.3%. Initiation with a nonrecommended nonnucleoside reverse transcriptase inhibitor-based vs a ritonavir-boosted protease inhibitor-based regimen resulted in a much smaller gain of around 100 CD4 cells/μL after 1 year. Patients on follow-up since 2007 had a median CD4 count of 498 cells/μL, and 87% had a pVL <40 copies/mL at the most recent follow-up visit. Conclusions This work provides unique data on HIV-1/O infection, in favor of a milder natural evolution than HIV-1 group M (HIV-1/M) and of a highly efficient current management, based on HIV-1/M guidelines, despite genetic divergence. Studies of comparable HIV-1/M and HIV-1/O populations are needed to confirm these results.
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Affiliation(s)
- Guillemette Unal
- Normandie Université, Université de Rouen Normandie (UNIROUEN), Groupe de Recherche sur l'Adaptation Microbienne (GRAM) EA2656, Centre Hospitalier Universitaire (CHU) de Rouen, Laboratoire de Virologie, associé au Centre National de Référence (CNR) du Virus de l'Immunodéficience Humaine (VIH).,Faculté de Médecine Paris Sud, Université Paris Sud, Université Paris-Saclay, Centre de recherche en Epidemiologie et Santé des Populations (CESP), Institut national de la santé et de la recherche médicale (INSERM) U1018, Centre de recherche en Epidémiologie et Santé des Populations, Le Kremlin Bicêtre
| | - Elodie Alessandri-Gradt
- Normandie Université, Université de Rouen Normandie (UNIROUEN), Groupe de Recherche sur l'Adaptation Microbienne (GRAM) EA2656, Centre Hospitalier Universitaire (CHU) de Rouen, Laboratoire de Virologie, associé au Centre National de Référence (CNR) du Virus de l'Immunodéficience Humaine (VIH)
| | - Marie Leoz
- Normandie Université, Université de Rouen Normandie (UNIROUEN), Groupe de Recherche sur l'Adaptation Microbienne (GRAM) EA2656, Centre Hospitalier Universitaire (CHU) de Rouen, Laboratoire de Virologie, associé au Centre National de Référence (CNR) du Virus de l'Immunodéficience Humaine (VIH)
| | - Juliette Pavie
- Hôpital Georges Pompidou, Faculté de Médecine, Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP)
| | - Clément Lefèvre
- Normandie Université, Université de Rouen Normandie (UNIROUEN), Groupe de Recherche sur l'Adaptation Microbienne (GRAM) EA2656, Centre Hospitalier Universitaire (CHU) de Rouen, Laboratoire de Virologie, associé au Centre National de Référence (CNR) du Virus de l'Immunodéficience Humaine (VIH)
| | - Henri Panjo
- Faculté de Médecine Paris Sud, Université Paris Sud, Université Paris-Saclay, Centre de recherche en Epidemiologie et Santé des Populations (CESP), Institut national de la santé et de la recherche médicale (INSERM) U1018, Centre de recherche en Epidémiologie et Santé des Populations, Le Kremlin Bicêtre
| | - Charlotte Charpentier
- Hôpital Bichat-Claude Bernard, AP-HP, Laboratoire de Virologie, INSERM, Infections Antimicrobials Modelling Evolution (IAME), Unité Mixte de Recherche (UMR) 1137, Université Paris Diderot, Sorbonne Paris Cité
| | - Diane Descamps
- Hôpital Bichat-Claude Bernard, AP-HP, Laboratoire de Virologie, INSERM, Infections Antimicrobials Modelling Evolution (IAME), Unité Mixte de Recherche (UMR) 1137, Université Paris Diderot, Sorbonne Paris Cité
| | - Francis Barin
- Laboratoire de virologie associé au CNR du VIH, INSERM U966, CHU de Tours
| | - François Simon
- University Hospital Saint Louis, Faculté de Médecine Paris Diderot, Paris
| | - Laurence Meyer
- Faculté de Médecine Paris Sud, Université Paris Sud, Université Paris-Saclay, Centre de recherche en Epidemiologie et Santé des Populations (CESP), Institut national de la santé et de la recherche médicale (INSERM) U1018, Centre de recherche en Epidémiologie et Santé des Populations, Le Kremlin Bicêtre.,Hôpital de Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
| | - Jean-Christophe Plantier
- Normandie Université, Université de Rouen Normandie (UNIROUEN), Groupe de Recherche sur l'Adaptation Microbienne (GRAM) EA2656, Centre Hospitalier Universitaire (CHU) de Rouen, Laboratoire de Virologie, associé au Centre National de Référence (CNR) du Virus de l'Immunodéficience Humaine (VIH)
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10
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Cappy P, Barlet V, Lucas Q, Tinard X, Pillonel J, Gross S, Tiberghien P, Laperche S. Transfusion of HIV-infected blood products despite highly sensitive nucleic acid testing. Transfusion 2019; 59:2046-2053. [PMID: 30784073 DOI: 10.1111/trf.15203] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/18/2019] [Accepted: 01/20/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND In France, the risk of HIV transmission by transfusion was reduced by implementing pooled nucleic acid testing (NAT) in 2001 and individual NAT in 2010. We report here the first case in France of transfusion of human immunodeficiency virus (HIV)-infected blood donated during HIV pre-ramp-up phase that tested individual NAT negative. METHODS Blood donations are screened for HIV antibodies and HIV RNA (ProcleixUltrio, Grifols; limit of detection at 95%, 23 copies/mL). When a repeat donor tests positive for HIV, a repository sample from the previous donation is tested with the Cobas Taqman HIV-1 test (CTM, Roche; limit of detection at 95%, 17 copies/mL). RESULTS In August 2017, a 57-year-old male repeat donor was screened positive for HIV antibodies and RNA (plasma viral load, 11,599 copies/mL). The previous donation had tested negative with Ultrio in March 2017 but was positive with an unquantifiable plasma viral load when tested with CTM. Sequencing showed no mismatch between Ultrio primers/probes and the target sequence. HIV transmission was excluded by lookback studies in the recipient of platelets, which had been pathogen reduced, but not in the recipient of RBCs due to premature death. CONCLUSION This case demonstrates that the risk of contaminated donations due to the early HIV infection phase going undetected by highly sensitive NAT is real but exceptional. The absence of transmission to the platelets recipient could be due to the very low viral inoculum and/or to the efficacy of the viral inactivation. This case also highlights the additional value of a systematic donation archiving and the importance of donor education and predonation selection.
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Affiliation(s)
- Pierre Cappy
- Département des Agents Transmissibles par le Sang, Centre National de Référence Risques Infectieux Transfusionnels, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - Valérie Barlet
- ETS Auvergne Rhône Alpes, Laboratoire de qualification biologique des dons Est, Etablissement Français du Sang, Metz-Tessy, France
| | - Quentin Lucas
- Département des Agents Transmissibles par le Sang, Centre National de Référence Risques Infectieux Transfusionnels, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - Xavier Tinard
- ETS grand est, Pôle des vigilances, Etablissement Français du Sang, Nancy, France
| | - Josiane Pillonel
- Département des maladies infectieuses, Santé publique France, Saint-Maurice, France
| | - Sylvie Gross
- Etablissement Français du Sang, Saint Denis, France
| | - Pierre Tiberghien
- Etablissement Français du Sang, Saint Denis, France.,Unité mixte de recherche 1098 INSERM, Université de Franche-Comté, Etablissement Français du Sang, Besançon, France
| | - Syria Laperche
- Département des Agents Transmissibles par le Sang, Centre National de Référence Risques Infectieux Transfusionnels, Institut National de la Transfusion Sanguine (INTS), Paris, France
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11
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Mourez T, Lemée V, Delbos V, Delaugerre C, Alessandri-Gradt E, Etienne M, Simon F, Chaix ML, Plantier JC. HIV rapid screening tests and self-tests: Be aware of differences in performance and cautious of vendors. EBioMedicine 2018; 37:382-391. [PMID: 30509399 PMCID: PMC6284408 DOI: 10.1016/j.ebiom.2018.10.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Rapid tests for HIV testing are essential tools to achieve the 90-90-90 target of the World Health Organization. Many tests are available, some directly from websites. Evaluation of the performance of rapid tests, under close to real-life usage, is therefore needed to ensure accurate diagnosis in the context of the recommendation for their more widespread use. METHOD Nine third- (3G) or fourth-generation (4G) rapid screening tests or self-tests (two bought on websites), were evaluated on an extensive panel of 200 HIV-negative and 312 HIV-positive samples, representative of a wide variety of clinical situations and HIV genetic diversity. A whole blood reconstitution protocol was designed to simulate real-life usage of these tests in community-based and private settings. FINDINGS The specificity was high (98.5-100%) and sensitivity excellent (100%) for samples from patients chronically infected with the pandemic strains. The performance for infrequent situations with a major epidemiological and clinical impact, such as infection with divergent viruses or primary infection, was highly variable, depending on the test. One of the two 4G tests allowed detection of additional positive samples from early stages of infection, whereas the second (sold as a 4G test on a website) corresponded in reality to a 3G test. INTERPRETATION Our study showed that not all tests are equal for the detection of major HIV variants or early stages of HIV infection; adding the detection of specific p24Ag improved the latter point. This study also showed, for the first time, that buying through web-based vendors can be risky, due to the varying performance of the tests and questionable sales practices. Our results are of particular importance in the context of the increasing use of rapid tests in an "outside laboratory" settings. FUND: Santé Publique France, COREVIH - Normandie, and Rouen University Hospital.
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Affiliation(s)
- Thomas Mourez
- Normandie Univ., UNIROUEN, GRAM EA 2656, Rouen University Hospital, Laboratory of Virology associated to the National Reference Centre for HIV, F-76000 Rouen, France
| | - Véronique Lemée
- Normandie Univ., UNIROUEN, GRAM EA 2656, Rouen University Hospital, Laboratory of Virology associated to the National Reference Centre for HIV, F-76000 Rouen, France
| | - Valérie Delbos
- Normandie Univ., UNIROUEN, GRAM EA 2656, Rouen University Hospital, Department of Infectious and Tropical Diseases, F-76000, Rouen, France
| | - Constance Delaugerre
- Denis Diderot - Paris 7 University, INSERM U941, APHP, Saint-Louis Hospital, Department of Virology, National Reference Centre for HIV, F-75010 Paris, France
| | - Elodie Alessandri-Gradt
- Normandie Univ., UNIROUEN, GRAM EA 2656, Rouen University Hospital, Laboratory of Virology associated to the National Reference Centre for HIV, F-76000 Rouen, France
| | - Manuel Etienne
- Normandie Univ., UNIROUEN, GRAM EA 2656, Rouen University Hospital, Department of Infectious and Tropical Diseases, F-76000, Rouen, France; Rouen University Hospital, COREVIH Haute-Normandie, F-76000 Rouen, France
| | - François Simon
- Denis Diderot - Paris 7 University, INSERM U941, APHP, Saint-Louis Hospital, Department of Virology, National Reference Centre for HIV, F-75010 Paris, France
| | - Marie-Laure Chaix
- Denis Diderot - Paris 7 University, INSERM U941, APHP, Saint-Louis Hospital, Department of Virology, National Reference Centre for HIV, F-75010 Paris, France
| | - Jean-Christophe Plantier
- Normandie Univ., UNIROUEN, GRAM EA 2656, Rouen University Hospital, Laboratory of Virology associated to the National Reference Centre for HIV, F-76000 Rouen, France.
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12
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Abstract
BACKGROUND The broad genetic divergence of HIV-1/O relative to HIV-1/M has important implications for diagnosis, monitoring and treatment. Despite this divergence, some HIV-1/M+O dual infections and HIV-1/MO recombinant forms have been reported, mostly in Cameroon, where both groups are prevalent. Here, we describe the characteristics of such infections detected in France in 10 new patients, and discuss their implications for biological and clinical practice, owing to the presence of group O species. METHODS The French National Reference Centre for HIV received samples within the framework of mandatory notification of HIV infections, and for expert analysis. A strategy combining serotyping, viral quantification, group-specific molecular amplification and whole-genome sequencing was used for strain characterization and complementary investigations. RESULTS We identified one patient with M+O infection, three patients with M+O infection associated with an MO recombinant, and six patients with only an MO recombinant. These atypical infections were detected upon strain characterization (n = 4) or because of anomalies during patient monitoring (n = 6). We identified eight new URF_MO, all but one originating from Cameroon. Interestingly, two distinct recombinant strains were found in two unrelated patients, representing possible precursors of a CRF_MO. CONCLUSION Our work highlights the fact that the continuous evolution of HIV can hinder diagnosis and complicate clinical practice. We stress that unexpected results during diagnosis or monitoring necessitate further serological and molecular exploration, these atypical infections influence biological and therapeutic management and necessitate appropriate tools, and specific surveillance is necessary, especially as the frequency of such infections may be underestimated.
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13
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Performance of the BioPlex 2200 HIV Ag-Ab assay for identifying acute HIV infection. J Clin Virol 2018; 99-100:67-70. [PMID: 29346085 DOI: 10.1016/j.jcv.2018.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 01/10/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Assays that detect HIV antigen (Ag) and antibody (Ab) can be used to screen for HIV infection. OBJECTIVES To compare the performance of the BioPlex 2200 HIV Ag-Ab assay and two other Ag/Ab combination assays for detection of acute HIV infection. STUDY DESIGN Samples were obtained from 24 individuals (18 from the US, 6 from South Africa); these individuals were classified as having acute infection based on the following criteria: positive qualitative RNA assay; two negative rapid tests; negative discriminatory test. The samples were tested with the BioPlex assay, the ARCHITECT HIV Ag/Ab Combo test, the Bio-Rad GS HIV Combo Ag-Ab EIA test, and a viral load assay. RESULTS Twelve (50.0%) of 24 samples had RNA detected only ( > 40 to 13,476 copies/mL). Ten (43.5%) samples had reactive results with all three Ag/Ab assays, one sample was reactive with the ARCHITECT and Bio-Rad assays, and one sample was reactive with the Bio-Rad and BioPlex assays. The 11 samples that were reactive with the BioPlex assay had viral loads from 83,010 to >750,000 copies/mL; 9/11 samples were classified as Ag positive/Ab negative by the BioPlex assay. CONCLUSIONS Detection of acute HIV infection was similar for the BioPlex assay and two other Ag/Ab assays. All three tests were less sensitive than a qualitative RNA assay and only detected HIV Ag when the viral load was high. The BioPlex assay detected acute infection in about half of the cases, and identified most of those infections as Ag positive/Ab negative.
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14
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Ngo-Malabo ET, Ngoupo T PA, Zekeng M, Ngono V, Ngono L, Sadeuh-Mba SA, Njouom R, Kfutwah A. A cheap and open HIV viral load technique applicable in routine analysis in a resource limited setting with a wide HIV genetic diversity. Virol J 2017; 14:224. [PMID: 29137673 PMCID: PMC5686852 DOI: 10.1186/s12985-017-0893-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV infection in Cameroon is characterized by a great viral diversity with all HIV-1 groups (M, N, O, and P) and HIV-2 in circulation. HIV group determination is very important if tailored viral load analysis and treatments are to be applied. In our laboratory, HIV viral load is carried out using two platforms; Biocentric and Abbott depending on the HIV group identified. Biocentric which quantifies HIV-1 group M is a cheap and open system useful in resource limited settings. The objective of this study was to compare the viral load analyses of serologically group-indeterminate HIV samples using the two platforms with the view of reducing cost. METHODS Consecutive samples received between March and May 2014, and between August and September 2014 in our laboratory for HIV viral load analysis were included. All these samples were analyzed for their HIV groups using an in-house ELISA serotyping test. All HIV-1 group M samples were quantified using the Biocentric test while all other known atypical samples (HIV-1 groups N, O and P) were analyzed using the Abbott technique. HIV group-indeterminate samples (by serotyping) were quantified with both techniques. RESULTS Among the 6355 plasma samples received, HIV-1 group M was identified in 6026 (94.82%) cases; HIV-1 group O, in 20 (0.31%); HIV-1 group M + O, in 3 (0.05%) and HIV-2, in 3 (0.05%) case. HIV-group indeterminate samples represented about 4.76% (303/6355) and only 231 of them were available for analysis by Abbott Real-Time HIV-1 and Generic HIV Viral Load techniques. Results showed that 188 (81.39%) samples had undetectable viral load in both techniques. All the detectable samples showed high viral load, with a mean of 4.5 log copies/ml (range 2.1-6.5) for Abbott Real-Time and 4.5 log copies/ml (range 2-6.4) for Generic HIV Viral Load. The mean viral load difference between the two techniques was 0.03 log10 copies/ml and a good correlation was obtained (r 2 = 0.89; P < 0.001). CONCLUSION Our results suggest that cheaper and open techniques such as Biocentric could be useful alternatives for HIV viral load follow-up quantification in resource limited settings like Cameroon; even with its high viral diversity.
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Affiliation(s)
| | - Paul Alain Ngoupo T
- Virology Department, Centre Pasteur of Cameroon, Po Box 1274, Yaounde, Cameroon
| | - Martin Zekeng
- Virology Department, Centre Pasteur of Cameroon, Po Box 1274, Yaounde, Cameroon
| | - Valérie Ngono
- Virology Department, Centre Pasteur of Cameroon, Po Box 1274, Yaounde, Cameroon
| | - Laure Ngono
- Virology Department, Centre Pasteur of Cameroon, Po Box 1274, Yaounde, Cameroon
| | | | - Richard Njouom
- Virology Department, Centre Pasteur of Cameroon, Po Box 1274, Yaounde, Cameroon.
| | - Anfumbom Kfutwah
- Virology Department, Centre Pasteur of Cameroon, Po Box 1274, Yaounde, Cameroon
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15
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Njouom R, Ngono L, Mekinda-Gometi DD, Ndé CK, Sadeuh-Mba SA, Vernet MA, Tchendjou P, Vernet G. Evaluation of the performances of twelve rapid diagnostic tests for diagnosis of HIV infection in Yaounde, Cameroon. J Virol Methods 2017; 243:158-163. [PMID: 28219762 DOI: 10.1016/j.jviromet.2017.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 01/05/2017] [Accepted: 02/10/2017] [Indexed: 11/26/2022]
Abstract
According to the WHO/UNAIDS recommendations, an acceptable HIV rapid diagnostic tests (RDTs) has to perform a sensitivity≥99% and a specificity≥98%. Given the constant release of new RDTs for HIV testing in the market and the high HIV genetic diversity in Cameroon, it is interesting to monitor their performances in that setting. A total of 240 HIV positive (including 219 HIV-1 M, 15 HIV-1 O, 1 HIV-1 N, 1 HIV-1 M/O recombinant and 4 HIV-2) and 240 HIV negative plasma samples were used to evaluate twelve routinely used RDTs in Cameroon. A reference algorithm combining Enzyme Immunoassays and nucleic acid testing was used as gold standard. The sensitivity, specificity, positive predictive value, and negative predictive value of the twelve RDTs evaluated varied between 93.7 and 100%; 95.8 and 100%; 96.0 and 100%, and 94.1 and 100%, respectively. Five out of the twelve RDTs could not detect some HIV-1 O variants, one of them failed to detect an HIV-2 variant while all them efficiently detected HIV-1 N and HIV M/O recombinant. Our findings underscore the need to monitor the performances of RDTs to be used for HIV testing in Cameroon using locally obtained well-characterized samples panels.
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Affiliation(s)
- Richard Njouom
- Centre Pasteur of Cameroon, Member of the International Network of Pasteur Institutes, 451 Rue 2005, P.O. Box 1274, Yaounde II, Yaounde, Cameroon.
| | - Laure Ngono
- Centre Pasteur of Cameroon, Member of the International Network of Pasteur Institutes, 451 Rue 2005, P.O. Box 1274, Yaounde II, Yaounde, Cameroon.
| | - Desirée Denise Mekinda-Gometi
- Centre Pasteur of Cameroon, Member of the International Network of Pasteur Institutes, 451 Rue 2005, P.O. Box 1274, Yaounde II, Yaounde, Cameroon.
| | - Cyprien Kengne Ndé
- Centre Pasteur of Cameroon, Member of the International Network of Pasteur Institutes, 451 Rue 2005, P.O. Box 1274, Yaounde II, Yaounde, Cameroon.
| | - Serge Alain Sadeuh-Mba
- Centre Pasteur of Cameroon, Member of the International Network of Pasteur Institutes, 451 Rue 2005, P.O. Box 1274, Yaounde II, Yaounde, Cameroon.
| | - Marie-Astrid Vernet
- Centre Pasteur of Cameroon, Member of the International Network of Pasteur Institutes, 451 Rue 2005, P.O. Box 1274, Yaounde II, Yaounde, Cameroon.
| | - Patrice Tchendjou
- Centre Pasteur of Cameroon, Member of the International Network of Pasteur Institutes, 451 Rue 2005, P.O. Box 1274, Yaounde II, Yaounde, Cameroon.
| | - Guy Vernet
- Centre Pasteur of Cameroon, Member of the International Network of Pasteur Institutes, 451 Rue 2005, P.O. Box 1274, Yaounde II, Yaounde, Cameroon.
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16
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De Oliveira F, Mourez T, Vessiere A, Ngoupo PA, Alessandri-Gradt E, Simon F, Rousset D, Plantier JC. Multiple HIV-1/M + HIV-1/O dual infections and new HIV-1/MO inter-group recombinant forms detected in Cameroon. Retrovirology 2017; 14:1. [PMID: 28086923 PMCID: PMC5237259 DOI: 10.1186/s12977-016-0324-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 12/15/2016] [Indexed: 11/10/2022] Open
Abstract
Background
Due to the prevalence of HIV-1 group M and the endemicity of HIV-1 group O infections in Cameroon, patients may be infected with both viruses and/or with HIV-1/MO recombinant forms. Such atypical infections may be deleterious in terms of diagnosis and therapeutic management due to the high divergence of HIV-1/O. The aim of this study was to identify prospectively such atypical infections in Cameroon. Results
Based on serological screening by env-V3 serotyping and a molecular strategy using group-specific (RT)-PCRs, we identified 10 Cameroonian patients harboring three different profiles of infection: (1) 4 HIV-1/M + O dual infections without evidence of recombinant; (2) 5 recombinants associated with one or both parental strains; and (3) 1 new recombinant form without parental strains. Conclusions This work highlights the dynamic co-evolution of these two HIV groups in Cameroon that could lead to the emergence of a circulating recombinant form MO, and the need for accurate identification of such atypical infections for precise diagnosis, virological monitoring and therapeutic management with adapted tools.
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Affiliation(s)
- Fabienne De Oliveira
- GRAM EA2656, Université de Rouen, Rouen, France.,Laboratoire de Virologie, Laboratoire associé au Centre National de Référence du VIH, CHU Charles Nicolle, 76031, Rouen Cedex, France
| | - Thomas Mourez
- GRAM EA2656, Université de Rouen, Rouen, France.,Laboratoire de Virologie, Laboratoire associé au Centre National de Référence du VIH, CHU Charles Nicolle, 76031, Rouen Cedex, France
| | - Aurélia Vessiere
- Centre Pasteur du Cameroun, Yaoundé, Cameroon.,Infectious Diseases Data Observatory, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | | | - Elodie Alessandri-Gradt
- GRAM EA2656, Université de Rouen, Rouen, France.,Laboratoire de Virologie, Laboratoire associé au Centre National de Référence du VIH, CHU Charles Nicolle, 76031, Rouen Cedex, France
| | - François Simon
- Service de Microbiologie, APHP, CHU Saint Louis, INSERM U941, Faculté de Médecine Paris Diderot, Paris, France
| | - Dominique Rousset
- Centre Pasteur du Cameroun, Yaoundé, Cameroon.,Laboratoire de Virologie, Institut Pasteur de le Guyane, Cayenne, Guyane française, France
| | - Jean-Christophe Plantier
- GRAM EA2656, Université de Rouen, Rouen, France. .,Laboratoire de Virologie, Laboratoire associé au Centre National de Référence du VIH, CHU Charles Nicolle, 76031, Rouen Cedex, France.
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17
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Evaluation of Hologic Aptima HIV-1 Quant Dx Assay on the Panther System on HIV Subtypes. J Clin Microbiol 2016; 54:2575-81. [PMID: 27510829 DOI: 10.1128/jcm.01350-16] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/02/2016] [Indexed: 11/20/2022] Open
Abstract
Quantitation of the HIV-1 viral load in plasma is the current standard of care for clinical monitoring of HIV-infected individuals undergoing antiretroviral therapy. This study evaluated the analytical and clinical performances of the Aptima HIV-1 Quant Dx assay (Hologic, San Diego, CA) for monitoring viral load by using 277 well-characterized subtype samples, including 171 cultured virus isolates and 106 plasma samples from 35 countries, representing all major HIV subtypes, recombinants, and circulating recombinant forms (CRFs) currently in circulation worldwide. Linearity of the Aptima assay was tested on each of 6 major HIV-1 subtypes (A, B, C, D, CRF01_AE, and CRF02_AG) and demonstrated an R(2) value of ≥0.996. The performance of the Aptima assay was also compared to those of the Roche COBAS AmpliPrep/COBAS TaqMan HIV-1 v.2 (CAP/CTM) and Abbott m2000 RealTime HIV-1 (RealTime) assays on all subtype samples. The Aptima assay values averaged 0.21 log higher than the CAP/CTM values and 0.30 log higher than the RealTime values, and the values were >0.4 log higher than CAP/CTM values for subtypes F and G and than RealTime values for subtypes C, F, and G and CRF02_AG. Two samples demonstrated results with >1-log differences from RealTime results. When the data were adjusted by the average difference, 94.9% and 87.0% of Aptima results fell within 0.5 log of the CAP/CTM and RealTime results, respectively. The linearity and accuracy of the Aptima assay in correctly quantitating all major HIV-1 subtypes, coupled with the completely automated format and high throughput of the Panther system, make this system well suited for reliable measurement of viral load in the clinical laboratory.
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18
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Haleyur Giri Setty MK, Liu J, Mahtani P, Zhang P, Du B, Ragupathy V, Devadas K, Hewlett IK. Novel Time-Resolved Fluorescence Europium Nanoparticle Immunoassay for Detection of Human Immunodeficiency Virus-1 Group O Viruses Using Microplate and Microchip Platforms. AIDS Res Hum Retroviruses 2016; 32:612-9. [PMID: 26978478 DOI: 10.1089/aid.2014.0351] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Accurate detection and quantification of HIV-1 group O viruses have been challenging for currently available HIV assays. We have developed a novel time-resolved fluorescence (TRF) europium nanoparticle immunoassay for HIV-1 group O detection using a conventional microplate enzyme-linked immunosorbent assay (ELISA) and a microchip platform. We screened several antibodies for optimal reactivity with several HIV-1 group O strains and identified antibodies that can detect all the strains of HIV-1 group O that were available for testing. The antibodies were used to develop a conventional ELISA format assay and an in-house developed europium nanoparticle-based assay for sensitivity. The method was evaluated on both microwell plate and microchip platforms. We identified two specific and sensitive antibodies among the six we screened. The antibodies, C65691 and ANT-152, were able to quantify 15 and detect all 17 group O viruses, respectively, as they were broadly cross-reactive with all HIV-1 group O strains and yielded better signals compared with other antibodies. We have developed a sensitive assay that reflects the actual viral load in group O samples by using an appropriate combination of p24 antibodies that enhance group O detection and a highly sensitive TRF-based europium nanoparticle for detection. The combination of ANT-152 and C65690M in the ratio 3:1 was able to give significantly higher signals in our europium-based assay compared with using any single antibody.
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Affiliation(s)
| | - Jikun Liu
- Laboratory of Molecular Virology, CBER, FDA, Silver Spring, Maryland
| | - Prerna Mahtani
- Laboratory of Molecular Virology, CBER, FDA, Silver Spring, Maryland
| | - Panhe Zhang
- Laboratory of Molecular Virology, CBER, FDA, Silver Spring, Maryland
| | - Bingchen Du
- Laboratory of Molecular Virology, CBER, FDA, Silver Spring, Maryland
| | | | | | - Indira K. Hewlett
- Laboratory of Molecular Virology, CBER, FDA, Silver Spring, Maryland
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19
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A Multiplex PCR Approach for Detecting Dual Infections and Recombinants Involving Major HIV Variants. J Clin Microbiol 2016; 54:1282-8. [PMID: 26912747 DOI: 10.1128/jcm.03222-15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 02/16/2016] [Indexed: 02/07/2023] Open
Abstract
The cocirculation of different HIV types and groups can lead to dual infections and recombinants, which hinder diagnosis and therapeutic management. We designed two multiplex PCRs (mPCRs) coupled with capillary electrophoresis to facilitate the detection of such infections. The first, MMO2, targets three variants (HIV-1/M, HIV-1/O, and HIV-2), and the second, MMO, targets HIV-1/M and HIV-1/O. These mPCRs were validated on DNA and RNA extracts from 19 HIV-1/M, 12 HIV-1/O, and 13 HIV-2 cultures and from mixtures simulating dual infections. They were then assessed with DNA and RNA extracts from samples of 47 clinical monoinfections and HIV-1/M+O dual infections or infections with HIV-1/MO recombinants. Both mPCRs had excellent specificity. Sensitivities ranged from 80 to 100% for in vitro samples and from 58 to 100% for clinical samples, with the results obtained depending on the material used and the region of the genome concerned. Sensitivity was generally lower for DNA than for RNA and for amplifications of the integrase and matrix regions. In terms of global detection (at least one target gene for each strain), both mPCRs yielded a detection rate of 100% for in vitro samples. MMO2 detected 100% of the clinical strains from DNA and 97% from RNA, whereas MMO detected 100% of the strains from both materials. Thus, for in vitro and clinical samples, MMO2 was a useful tool for detecting dual infections with HIV-1 and HIV-2 (referred to as HIV-1+HIV-2) and HIV-1/M+O, and MMO was useful for detecting both MO dual infections and MO mosaic patterns.
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Yamazaki S, Kondo M, Sudo K, Ueda T, Fujiwara H, Hasegawa N, Kato S. Qualitative Real-Time PCR Assay for HIV-1 and HIV-2 RNA. Jpn J Infect Dis 2016; 69:367-72. [PMID: 26743143 DOI: 10.7883/yoken.jjid.2015.309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Because western blotting occasionally causes cross-reactions between human immunodeficiency virus (HIV)-1 and HIV-2, it is difficult to distinguish a coinfection status from a false-positive result. Therefore, we developed a qualitative real-time PCR assay to detect HIV-1 and HIV-2 RNA that can be performed in parallel. Viral RNA extracted from 500 μl of plasma was examined using real-time PCR with minor groove binder probes. Bovine leukemia virus was used as an internal standard. The sensitivity was determined by probit regression analysis using the World Health Organization international standards for HIV-1 and HIV-2. The lower detection limits at a 95% hit rate were 54 IU/ml for HIV-1 and 5.0 IU/ml for HIV-2, which were lower than any HIV-2 assays reported previously. HIV-1 RNA was detected in 51 of 52 HIV-1 seropositive plasma samples. HIV-2 RNA was detected in 7 of 10 HIV-2 seropositive plasma samples. Non-specific signals and cross reactivity between HIV-1 and HIV-2 were not observed in 100 HIV seronegative samples. The assay developed in this study is highly sensitive and specific for the detection of HIV-1 and HIV-2 RNA. The test is expected to be useful for the differential diagnosis of HIV-1 and HIV-2 infections.
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Affiliation(s)
- Sayaka Yamazaki
- Department of Microbiology and Immunology, Keio University School of Medicine
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Abstract
OBJECTIVE Despite the genetic divergence between HIV-1 groups M and O, HIV-1 M/O intergroup recombinants were reported. Actually, there is no data on the transmissibility of such recombinant forms. During a surveillance of HIV genetic diversity in Cameroon, we investigated the possible direct transmission of an HIV-1 M/O recombinant virus in an HIV-infected couple. METHODS Consecutive samples obtained from the couple were analysed for detection of dual HIV-1 groups M and O infections, and HIV-1 M/O recombinant forms. Analyses were performed using a serological and molecular algorithm based on HIV serotyping and group-specific PCRs targeting the polymerase and envelope genes. Pattern characterization of the strains found in both patients was based on complete genome sequencing. Phylogenetic and similarity profile analyses were performed to investigate the genetic relationship between viruses from both spouses and the previously described recombinant forms. RESULTS The sero-molecular algorithm data showed a group O serotype confirmed by molecular analysis in the envelope regions, whereas molecular tests identified HIV-1 group M in the polymerase. Phylogenetic analyses and similarity profiles of the full-length genome sequences showed that both spouses were infected with a unique recombinant virus having two recombination breakpoints in the vpr gene and LTR region. No phylogenetic link was found with the previous M/O recombinants. CONCLUSION We provide, for the first time, molecular evidence of direct transmission of an HIV-1 M/O recombinant, highlighting the potential spread of these divergent viruses. The importance of HIV-1 recombination on genetic evolution and public health when implying divergent strains as group O has to be carefully considered.
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Gautheret-Dejean A, Bocobza J, Brunet S, Damond F, Plantier JC, Barin F. Performance of rapid tests for discrimination between HIV-1 and/or HIV-2 infections. J Med Virol 2015; 87:2061-6. [PMID: 26081750 DOI: 10.1002/jmv.24282] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2015] [Indexed: 11/11/2022]
Abstract
Major differences exist between HIV-1 and HIV-2 in terms of epidemiology, pathogenicity, sensitivity to antiretrovirals. Determining the type of HIV infecting a patient is essential for management. The aim of this study was to evaluate the ability of simple/rapid tests to differentiate between HIV-1 and/or HIV-2 infections. We analyzed 116 samples from patients infected with HIV-1 (n = 61), HIV-2 (n = 47), or HIV-1+HIV-2 (n = 8) at the chronic stage of infection. Each sample was tested with SD Bioline HIV-1/2 3.0, ImmunoFlow HIV1-HIV2, ImmunoFlow HIV1-HIV2 (WB), Genie III HIV-1/HIV-2, ImmunoComb HIV1&2 BiSpot. HIV-1, or HIV-2 single infection was identified with a sensitivity ranging from 90% to 100%. The ability to detect dual infection was less sensitive (12.5-100%). SD Bioline HIV-1/2 3.0, ImmunoFlow HIV1-HIV2, and Genie III were unable to detect HIV-1 group O infection in one, one and two cases, respectively. The specificity of detection of HIV-1, HIV-2, or HIV-1+HIV-2 antibodies differed greatly (36-100%). ImmunoComb BiSpot had the highest sensitivity values (99-100% for HIV-1, 98% for HIV-2, and 75-87.5% for dual infection) and specificity values (94-100% for HIV-1, 100% for HIV-2, and 97-100% for dual infection). In conclusion, this study showed that no single rapid test had a perfect sensitivity/specificity ratio, particularly in the case of the double infections.
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Affiliation(s)
- Agnès Gautheret-Dejean
- Sorbonne Universités, UPMC Université Paris 6, UMRS CR7, INSERM U1135, Persistent Viral Infections, CIMI-Paris, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Paris, France.,AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Virologie, Paris, France.,Sorbonne Paris Cité, Université René Descartes Paris 5, UFR des Sciences Pharmaceutiques et Biologiques, Laboratoire de Microbiologie, Paris, France
| | - Jonathan Bocobza
- Sorbonne Universités, UPMC Université Paris 6, UMRS CR7, INSERM U1135, Persistent Viral Infections, CIMI-Paris, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Paris, France.,AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Virologie, Paris, France
| | - Sylvie Brunet
- Centre Hospitalier Régional Universitaire, Centre National de Référence du VIH, Tours, France
| | - Florence Damond
- AP-HP, Groupe Hospitalier Universitaire Paris Nord-Val de Seine, Laboratoire de Virologie, Paris, France
| | - Jean-Christophe Plantier
- Université de Rouen, Centre Hospitalo-Universitaire Charles Nicolle and EA2656-GRAM, Laboratoire associé au Centre National de Référence du VIH, Rouen, France
| | - Francis Barin
- Centre Hospitalier Régional Universitaire, Centre National de Référence du VIH, Tours, France.,Université François-Rabelais, INSERM UMR966, Tours, France
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Performance of the Liaison XL Murex HIV Ab/Ag test on clinical samples representing current epidemic HIV variants. J Clin Microbiol 2014; 52:3277-9. [PMID: 24966360 DOI: 10.1128/jcm.01089-14] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Screening for HIV infection has improved since the first immunoassays. Today, diagnosis of HIV infection can be performed with fourth-generation tests that track both the patient's antibodies and HIV antigen. The objective of this study was to evaluate the clinical sensitivity and specificity of the new DiaSorin Liaison XL Murex HIV Ab/Ag assay compared to another fourth-generation assay, the Abbott Architect HIV Ag/Ab Combo kit. This work was performed on a large panel of 900 samples, including negative samples (n = 493) and HIV-positive (n = 407) representatives of HIV-1 group M subtypes and circulating recombinant forms (CRFs), HIV-1 group O, and HIV-2 variants. The results highlight the high specificity (98.9%) and sensitivity (100%) of this new fourth-generation assay, which are consistent with its use for the screening and diagnosis of HIV infections with the current circulating strains.
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Abstract
The AIDS pandemic that started in the early 1980s is due to human immunodeficiency virus type 1 (HIV-1) group M (HIV-M), but apart from this major group, many divergent variants have been described (HIV-1 groups N, O, and P and HIV-2). The four HIV-1 groups arose from independent cross-species transmission of the simian immunodeficiency viruses (SIVs) SIVcpz, infecting chimpanzees, and SIVgor, infecting gorillas. This, together with human adaptation, accounts for their genomic, phylogenetic, and virological specificities. Nevertheless, the natural course of non-M HIV infection seems similar to that of HIV-M. The virological monitoring of infected patients is now possible with commercial kits, but their therapeutic management remains complex. All non-M variants were principally described for patients linked to Cameroon, where HIV-O accounts for 1% of all HIV infections; only 15 cases of HIV-N infection and 2 HIV-P infections have been reported. Despite improvements in our knowledge, many fascinating questions remain concerning the origin, genetic evolution, and slow spread of these variants. Other variants may already exist or may arise in the future, calling for close surveillance. This review provides a comprehensive, up-to-date summary of the current knowledge on these pathogens, including the historical background of their discovery; the latest advances in the comprehension of their origin and spread; and clinical, therapeutic, and laboratory aspects that may be useful for the management and the treatment of patients infected with these divergent viruses.
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Clinical evaluation of BioPlex 2200 HIV Ag-Ab, an automated screening method providing discrete detection of HIV-1 p24 antigen, HIV-1 antibody, and HIV-2 antibody. J Clin Microbiol 2013; 52:103-7. [PMID: 24153130 DOI: 10.1128/jcm.02460-13] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Early and accurate diagnosis is essential for optimal therapeutic outcomes in patients infected with HIV. Currently, none of the commercially available fourth-generation assays differentiate HIV-1 and HIV-2 antibodies (Ab) or the HIV-1 p24 antigen (Ag). The aim of this study was to evaluate the performance of a novel assay, the BioPlex 2200 HIV Ag-Ab. This assay uses a multiplex flow immunoassay design allowing the simultaneous detection and identification of antibodies to HIV-1 (groups M and O), HIV-2, and the HIV-1 p24 antigen, in addition to providing a traditional composite result. A total of 1,505 routine serum samples were prospectively tested. Results were compared with those from the Architect HIV Combo assay. The sensitivity of the BioPlex 2200 was 100%. The specificity assessed on repeated false-positive samples was 99.5%. In addition, 524 frozen specimens from patients known to be infected with HIV-1 or HIV-2 were tested. Of these specimens, 420 were infected with HIV-1, including 156 of known genotypes, 86 were infected with HIV-2, 7 were infected with HIV-1 and HIV-2, and 11 were from patients with acute HIV infection. Sensitivity was 100% for the HIV genotypes tested. The differentiation capabilities of the BioPlex 2200 HIV Ag-Ab assay for HIV-1, HIV-2, dual HIV-1/HIV-2, and early infections were 100%, 90.7%, 100%, and 90.9%, respectively. The BioPlex 2200 is a sensitive and specific assay that offers advantages over conventional HIV combo assays, also referred to as fourth-generation assays, to accurately differentiate and report HIV-1 p24 antigen and HIV-1 and HIV-2 antibodies.
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Kfutwah A, Lemée V, Ngono HV, De Oliveira F, Njouom R, Plantier JC. Field evaluation of the Abbott ARCHITECT HIV Ag/Ab Combo immunoassay. J Clin Virol 2013; 58 Suppl 1:e70-5. [PMID: 24342480 DOI: 10.1016/j.jcv.2013.08.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 08/09/2013] [Accepted: 08/17/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Fourth generation assays for HIV diagnosis are progressively being introduced into routine services, due to their improvement of diagnosis. In spite of this, HIV diagnosis remains a challenge in sub-Saharan Africa, due to false positive reactivity. There is a continuous need for field evaluations and routine validations of fourth generation HIV tests in African populations. OBJECTIVES Evaluate the performances of the ARCHITECT HIV Ag/Ab kit (Abbott) in a population living in an African setting-Cameroon compared to a population living in a European setting-France. STUDY DESIGN 645 HIV samples from both France and Cameroon were evaluated. The positive panel (378 samples) included a diverse series of HIV-1 variants (groups M, N, O, and P) as well as HIV-2 samples. Results were compared to original diagnosis done with other 4th generation assays (AxSYM HIV Ag/Ab (Abbott) and Vidas HIV DUO QUICK) (bioMérieux). RESULTS Sensitivity of the ARCHITECT was 100% in both sites. It diagnosed all variants of the panel with different reactivity profiles following strain diversity. A wider range of reactivity was observed for group O. Specificity was slightly lower (97.6%) in Cameroon than in France (98.6%), probably due to a higher rate of false positive reactivity. ARCHITECT HIV Ag/Ab assay had high performances in clinical sensitivity and specificity and is adapted to the wide genetic diversity of viruses circulating in West Central Africa. CONCLUSION Our results further highlight the need to evaluate HIV diagnostic tests before introduction into routine diagnostic services both in the North and in the South.
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Affiliation(s)
- Anfumbom Kfutwah
- Service de Virologie, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaounde', Cameroun. BP 1274, Yaounde, Cameroon.
| | - Véronique Lemée
- Laboratoire Associé au Centre National de Référence du VIH, Hôpital Charles Nicolle, CHU de Rouen, 76031 Rouen, France
| | - Hélène Valérie Ngono
- Service de Virologie, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaounde', Cameroun. BP 1274, Yaounde, Cameroon
| | - Fabienne De Oliveira
- Laboratoire Associé au Centre National de Référence du VIH, Hôpital Charles Nicolle, CHU de Rouen, 76031 Rouen, France
| | - Richard Njouom
- Service de Virologie, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaounde', Cameroun. BP 1274, Yaounde, Cameroon
| | - Jean-Christophe Plantier
- Laboratoire Associé au Centre National de Référence du VIH, Hôpital Charles Nicolle, CHU de Rouen, 76031 Rouen, France.
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Raltegravir-based regimens are effective in HIV-1 group O-infected patients. J Acquir Immune Defic Syndr 2012; 61:e1-3. [PMID: 22918125 DOI: 10.1097/qai.0b013e31826327c4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ly TD, Plantier JC, Leballais L, Gonzalo S, Lemée V, Laperche S. The variable sensitivity of HIV Ag/Ab combination assays in the detection of p24Ag according to genotype could compromise the diagnosis of early HIV infection. J Clin Virol 2012; 55:121-7. [DOI: 10.1016/j.jcv.2012.06.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 06/20/2012] [Indexed: 10/28/2022]
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Oliveira V, Bártolo I, Borrego P, Rocha C, Valadas E, Barreto J, Almeida E, Antunes F, Taveira N. Genetic diversity and drug resistance profiles in HIV type 1- and HIV type 2-infected patients from Cape Verde Islands. AIDS Res Hum Retroviruses 2012; 28:510-22. [PMID: 21902592 DOI: 10.1089/aid.2011.0174] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Our aim was to characterize for the first time the genetic diversity of HIV in Cape Verde Islands as well as the drug resistance profiles in treated and untreated patients. Blood specimens were collected from 41 HIV-1 and 14 HIV-2 patients living in Santiago Island. Half of the patients were on antiretroviral treatment (ART). Pol and env gene sequences were obtained using in-house methods. Phylogenetic analysis was used for viral subtyping and the Stanford Algorithm was used for resistance genotyping. For HIV-1, the amplification of pol and env was possible in 27 patients (66%). HIV-1 patients were infected with subtypes G (13, 48%), B (2, 7%), F1 (2, 7%), and CRF02_AG (2, 7%), and complex recombinant forms including a new C/G variant (n=8, 30%). Drug resistance mutations were detected in the PR and RT of three (10%) treated patients. M41L and K103N transmitted drug resistance mutations were found in 2 of 17 (12%) untreated patients. All 14 HIV-2 isolates belonged to group A. The origin of 12 strains was impossible to determine whereas two strains were closely related to the historic ROD strain. In conclusion, in Cape Verde there is a long-standing HIV-2 epidemic rooted in ROD-like strains and a more recent epidemic of unknown origin. The HIV-1 epidemic is caused by multiple subtypes and complex recombinant forms. Drug resistance HIV-1 strains are present at moderate levels in both treated and untreated patients. Close surveillance in these two populations is crucial to prevent further transmission of drug-resistant strains.
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Affiliation(s)
- Vânia Oliveira
- Laboratório de Hemato-Oncologia, Instituto Português de Oncologia, Lisbon, Portugal
- Unidade dos Retrovírus e Infecções Associadas, Centro de Patogénese Molecular, Faculdade de Farmácia de Lisboa, Lisbon, Portugal
| | - Inês Bártolo
- Unidade dos Retrovírus e Infecções Associadas, Centro de Patogénese Molecular, Faculdade de Farmácia de Lisboa, Lisbon, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz, Monte de Caparica, Portugal
| | - Pedro Borrego
- Unidade dos Retrovírus e Infecções Associadas, Centro de Patogénese Molecular, Faculdade de Farmácia de Lisboa, Lisbon, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz, Monte de Caparica, Portugal
| | - Cheila Rocha
- Unidade dos Retrovírus e Infecções Associadas, Centro de Patogénese Molecular, Faculdade de Farmácia de Lisboa, Lisbon, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz, Monte de Caparica, Portugal
| | - Emília Valadas
- Clínica Universitária de Doenças Infecciosas/Serviço de Doenças Infecciosas, Faculdade de Medicina de Lisboa/Hospital de Santa Maria, Lisbon, Portugal
| | - Jorge Barreto
- Hospital Dr. Agostinho Neto, Delegacia de Saúde, Cidade da Praia, Cabo Verde
| | - Elsa Almeida
- Hospital Dr. Agostinho Neto, Delegacia de Saúde, Cidade da Praia, Cabo Verde
| | - Francisco Antunes
- Clínica Universitária de Doenças Infecciosas/Serviço de Doenças Infecciosas, Faculdade de Medicina de Lisboa/Hospital de Santa Maria, Lisbon, Portugal
| | - Nuno Taveira
- Unidade dos Retrovírus e Infecções Associadas, Centro de Patogénese Molecular, Faculdade de Farmácia de Lisboa, Lisbon, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz, Monte de Caparica, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
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A new real-time quantitative PCR for diagnosis and monitoring of HIV-1 group O infection. J Clin Microbiol 2011; 50:831-6. [PMID: 22170927 DOI: 10.1128/jcm.05669-11] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The correct diagnosis and monitoring of HIV-1 group O (HIV-O) infection are essential for appropriate patient management, for the prevention of mother-to-child transmission, and for the detection of dual HIV-M/HIV-O infections. HIV-O RNA quantification is currently possible with two commercial kits (from Abbott and Roche), which quantify HIV-M and HIV-O strains indifferently; therefore, they cannot be used for the specific identification of HIV-O infection. We designed a new real-time quantitative reverse transcription PCR (RT-qPCR assay) (INT-O), which we compared with our previous version, LTR-O, and with the Abbott RealTime HIV-1 kit. Specificity was assessed with 27 HIV-1 group M strains and the prototype strain of group P. Clinical performances were analyzed by using 198 stored plasma samples, representative of HIV-O genetic diversity. Analytical sensitivity, repeatability, and reproducibility were also determined. The detection limit of the INT-O assay was 40 copies/ml, and its specificity was 100%. The repeatability and reproducibility were excellent. Analysis of clinical samples showed a good correlation between the INT-O and LTR-O assays (r = 0.8240), with an improvement of analytical sensitivity. A good correlation was also obtained between the INT-O and Abbott assays (r = 0.8599) but with significantly higher values (0.19 logs) for the INT-O method, due to marked underquantifications for some patients. These results showed that HIV-O genetic diversity still has an impact on RNA quantification. The new assay, INT-O, allows both the specific diagnosis of HIV-O infection and the quantification of diverse HIV-O strains. Its detection limit is equivalent to that of commercial kits. This assay is cheap and suitable for use in areas in which strains of HIV-1 groups M and O cocirculate.
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Impact of HIV-1 group O genetic diversity on genotypic resistance interpretation by algorithms designed for HIV-1 group M. J Acquir Immune Defic Syndr 2011; 56:139-45. [PMID: 21233638 DOI: 10.1097/qai.0b013e318201a904] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND HIV-1 group O (HIV-O) is characterized by a high genetic divergence from HIV-1 group M viruses. Little is known about the therapeutic impact of this diversity. The aim of this study was to assess in a large series of samples (1) the genotypic impact of natural polymorphism of the HIV-O reverse transcriptase and protease genes; and (2) the predictive value of resistance interpretation algorithms developed for HIV-1 group M when used for highly mutated HIV-O viruses. METHODS Sixty-eight antiretroviral-naive and 9 highly antiretroviral-experienced HIV-O-infected patients were included. The viruses were sequenced and resistance-associated mutations were identified using 3 different algorithms (Agence Nationale de Recherches sur le SIDA et les hépatites virales, Rega, Stanford). RESULTS All HIV-O samples naturally exhibited the A98G and V179E resistance mutations in the reverse transcriptase region; 54% of samples presented the Y181C mutation, conferring resistance to nonnucleoside reverse transcriptase inhibitors. Twelve minor resistance mutations, present in more than 75% of the protease sequences, led to the different algorithms giving discrepant results for nelfinavir and saquinavir susceptibility. A marked virological response was observed in 8 of the 9 antiretroviral-experienced patients, despite the prediction of limited activity of the combination for 5 to 8 patients according to the algorithm used. CONCLUSIONS The high level of natural polymorphism in HIV-O genes, and the important discrepancies between genotypic resistance interpretation and the virological response, emphasize the need for resistance algorithm rules better adapted to HIV-O.
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Tagny CT, Mbanya D, Leballais L, Murphy E, Lefrère JJ, Laperche S. Reduction of the risk of transfusion-transmitted human immunodeficiency virus (HIV) infection by using an HIV antigen/antibody combination assay in blood donation screening in Cameroon. Transfusion 2011; 51:184-90. [DOI: 10.1111/j.1537-2995.2010.02782.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lefrère JJ, Dahourouh H, Dokekias AE, Kouao MD, Diarra A, Diop S, Tapko JB, Murphy EL, Laperche S, Pillonel J. Estimate of the residual risk of transfusion-transmitted human immunodeficiency virus infection in sub-Saharan Africa: a multinational collaborative study. Transfusion 2010; 51:486-92. [DOI: 10.1111/j.1537-2995.2010.02886.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Depatureaux A, Leoz M, De Oliveira F, Gueudin M, Damond F, Descamps D, Brun-Vézinet F, Lemée V, Simon F, Barin F, Plantier JC. [Specific diagnosis and follow-up of HIV-1 group O infection: RES-O data]. Med Mal Infect 2010; 40:669-76. [PMID: 20646884 DOI: 10.1016/j.medmal.2010.04.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2009] [Revised: 01/04/2010] [Accepted: 04/21/2010] [Indexed: 10/19/2022]
Abstract
INTRODUCTION HIV-1 group O (HIV-O), mainly found in Cameroon, has a very high genetic diversity with consequences on the diagnosis and treatment of patients, requiring the development of specific tools. OBJECTIVE We present the currently available tools for the specific detection of HIV-O and its therapeutic monitoring, and the first RES-O data, a French network for the identification and monitoring of patients infected by HIV-O. METHOD The diagnosis of infection was confirmed by group-specific envelope serotyping. The viral load was assessed by a specific technique, LTR-O, developed in the laboratory and compared to the nonspecific kit RealTime HIV-1 (Abbott). The sequencing of antiretroviral target regions (Protease, Reverse Transcriptase (RT), Integrase and Gp41), was performed by specific primers. The analysis of resistance mutations was performed with the ANRS algorithm used for HIV-M. RESULTS HIV-O infection was confirmed for 117 patients. Measuring viral load showed the two techniques were equivalent, but with a tendency to under-quantification for the Abbott technique greater than 1 log for 5% of samples. 70 to 100% of the studied strains had at least 10 mutations in the Protease, four 4 in the RT, and one in Gp41, resulting in a natural genotypic resistance to some anti-retroviral molecules. DISCUSSION The diagnosis and monitoring of HIV-O infection is now possible. However, the impact of this variant's natural polymorphism on response to treatment remains undocumented.
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Affiliation(s)
- A Depatureaux
- Laboratoire associé au CNR du VIH, EA 2656, CHU Charles-Nicolle, 76031 Rouen, France
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Baseline genotypic and phenotypic susceptibilities of HIV-1 group O to enfuvirtide. Antimicrob Agents Chemother 2010; 54:4016-9. [PMID: 20547806 DOI: 10.1128/aac.00100-10] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We assessed the natural genotypic and phenotypic susceptibilities to enfuvirtide of 171 HIV group O (HIV-O) samples and 29 strains, respectively. The N42D resistance-associated mutation in the gp41 region was detected in 98% of cases. The phenotypic assay showed a wide range of baseline susceptibilities, with 50% inhibitory concentrations (IC(50)s) from 4 to 5,000 nM, a range similar to that reported for HIV-1 group M. Thus, despite the natural genotypic resistance conferred by the N42D signature mutation, HIV-O variants appear to be phenotypically susceptible. Enfuvirtide could therefore potentially be used in antiretroviral treatments for HIV-O-infected patients.
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Molecular epidemiology of simian immunodeficiency virus infection in wild-living gorillas. J Virol 2009; 84:1464-76. [PMID: 19906908 DOI: 10.1128/jvi.02129-09] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Chimpanzees and gorillas are the only nonhuman primates known to harbor viruses closely related to HIV-1. Phylogenetic analyses showed that gorillas acquired the simian immunodeficiency virus SIVgor from chimpanzees, and viruses from the SIVcpz/SIVgor lineage have been transmitted to humans on at least four occasions, leading to HIV-1 groups M, N, O, and P. To determine the geographic distribution, prevalence, and species association of SIVgor, we conducted a comprehensive molecular epidemiological survey of wild gorillas in Central Africa. Gorilla fecal samples were collected in the range of western lowland gorillas (n = 2,367) and eastern Grauer gorillas (n = 183) and tested for SIVgor antibodies and nucleic acids. SIVgor antibody-positive samples were identified at 2 sites in Cameroon, with no evidence of infection at 19 other sites, including 3 in the range of the Eastern gorillas. In Cameroon, based on DNA and microsatellite analyses of a subset of samples, we estimated the prevalence of SIVgor to be 1.6% (range, 0% to 4.6%), which is significantly lower than the prevalence of SIVcpzPtt in chimpanzees (5.9%; range, 0% to 32%). All newly identified SIVgor strains formed a monophyletic lineage within the SIVcpz radiation, closely related to HIV-1 groups O and P, and clustered according to their field site of origin. At one site, there was evidence for intergroup transmission and a high intragroup prevalence. These isolated hot spots of SIVgor-infected gorilla communities could serve as a source for human infection. The overall low prevalence and sporadic distribution of SIVgor could suggest a decline of SIVgor in wild populations, but it cannot be excluded that SIVgor is still more prevalent in other parts of the geographical range of gorillas.
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