One or two enzyme-linked immunosorbent assay tests on the first serum sample for initial diagnosis of HIV-1 infection?

International audienceIn France, the first sample for the initial diagnosis of HIV-1 infection must be tested with two antibody assays: one being an enzyme-linked immunosorbent assay. If one is positive, confirmation tests are performed. We evaluated the performance of initial diagnostic strategies based on the use of one versus two enzyme-linked immunosorbent assay tests, either an antigen-antibody test or a simple antibody assay. We found that a single antigen-antibody test was more efficient than a combination of the two tests

Hepatitis C virus prevalence and genetic diversity among pregnant women in Gabon, central Africa

Abstract Background Hepatitis C virus (HCV) infection is a major global public health problem in both developed and developing countries. The prevalence and genetic diversity of HCV in pregnant women in Gabon, central Africa, is not known. We therefore evaluated the prevalence and the circulating genotypes of HCV in a large population cohort of pregnant women. Methods Blood samples (947) were collected from pregnant women in the five main cities of the country. The prevalence was evaluated by two ELISA tests, and the circulating genotypes were characterized by sequencing and phylogenetic analysis. Results Twenty pregnant women (2.1%) were infected with HCV. The seroprevalence differed significantly by region (p = 0.004) and increased significantly with age (p = 0.05), being 1.3% at 14–20 years, 1.1% at 21–25 years, 1.9% at 26–30 years, 4.1% at 31–35 years and 6.0% at > 35 years. Sequencing in the 5'-UTR and NS5B regions showed that the circulating strains belonged to genotypes 4 (4e and 4c). Conclusion We found that the HCV seroprevalence in pregnant women in Gabon is almost as high as that in other African countries and increases with age. Furthermore, only genotype 4 (4e and 4c) was found. More extensive studies aiming to evaluate the prevalence and heterogeneity of HCV genotypes circulating in the general population of the country are needed.</p

Comparison of viro-immunological marker changes between HIV-1 and HIV-2-infected patients in France.: Comparison between HIV-1 and HIV-2 in France

International audienceBACKGROUND: HIV-2 is known to be less pathogenic than HIV-1, although the underlying mechanisms are still debated. We compared the changes over time in viro-immunological markers in HIV-1 and HIV-2-infected patients living in France during natural history and after initiation of the first combination antiretroviral therapy (CART). METHOD: Patients were included in the ANRS CO3 HIV-1 cohort (N = 6707) or the ANRS CO5 HIV-2 cohort (N = 572). HIV-1-infected patients were matched to HIV-2 patients according to sex, age, HIV transmission group and period of treatment initiation. Changes in markers were estimated using linear mixed models. RESULTS: Analyses were performed for three groups of patients: those with estimated date of contamination (98 HIV-1 and 49 HIV-2-seroincident patients); untreated seroprevalent patients (320 HIV-1 and 160 HIV-2); and those initiating a first CART (59 HIV-1 and 63 HIV-2). In group 1, CD4 T-cell counts decreased less rapidly in HIV-2 than HIV-1 patients (-9 versus -49 cells/microl per year, P < 10(-4)). Results were similar in group 2. Baseline CD4 cell count at CART initiation was not different according to the type of infection. During the first 2 months of treatment, the CD4 cell count increased by +59 cells/microl per month (CI 34; 84) for HIV-1 and +24 (CI 6; 42) for HIV-2. The plasma viral load drop was threefold more important in HIV-1 patients: -1.56 log10/ml per month versus -0.62 among HIV-2 patients (P < 10(-4)). CONCLUSION: Differences between the two infections during natural history are similar to those previously described in Africa. Once treatment is started, response is poorer in HIV-2 than in HIV-1 patients

Molecular testing of multiple HIV-1 transmissions in a criminal case.

OBJECTIVE: To test the a priori hypothesis of HIV-1 transmission from one suspect to six recipients in a criminal case. METHODS: Partial pol and/or env sequences were obtained for at least two samples of the suspect and the victims. Appropriate local controls were sampled based on epidemiological and subtype criteria. Phylogenetic testing was performed using different reconstruction methods. RESULTS: Phylogenetic analyses consistently inferred a monophyletic cluster for the suspect and victim samples in both genome regions. This was highly supported by parametric and non-parametric bootstrapping techniques. Moreover, the controls most closely related to the suspect-victim cluster had a similar geographical origin to the suspect. CONCLUSIONS: Taking into account the limitations on the conclusions that can be drawn from molecular investigations we could infer that our molecular data is consistent with a scenario of multiple HIV transmission between suspect and victims

Molecular testing of multiple HIV-1 transmissions in a criminal case

OBJECTIVE: To test the a priori hypothesis of HIV-1 transmission from one suspect to six recipients in a criminal case. METHODS: Partial pol and/or env sequences were obtained for at least two samples of the suspect and the victims. Appropriate local controls were sampled based on epidemiological and subtype criteria. Phylogenetic testing was performed using different reconstruction methods. RESULTS: Phylogenetic analyses consistently inferred a monophyletic cluster for the suspect and victim samples in both genome regions. This was highly supported by parametric and non-parametric bootstrapping techniques. Moreover, the controls most closely related to the suspect-victim cluster had a similar geographical origin to the suspect. CONCLUSIONS: Taking into account the limitations on the conclusions that can be drawn from molecular investigations we could infer that our molecular data is consistent with a scenario of multiple HIV transmission between suspect and victims.status: publishe

First-line highly active antiretroviral regimens in 2001-2002 in the French Hospital Database on HIV: combination prescribed and biological outcomes.: First-line haart : combination prescribed and biological outcomes.

INTRODUCTION: We compared biological outcomes in antiretroviral-naive patients with viral load (VL) > 5,000 copies/ml starting combivir-based, three-drug highly active antiretroviral therapy regimens in 2001-2002 according to the third component, namely abacavir (ABC), nelfinavir (NFV), indinavir/ritonavir (IDV/r), lopinavir/ritonavir (LPV/r), nevirapine (NVP) or efavirenz (EFV). METHODS: We evaluated virological response (HIV RNA or = 50 CD4+ T-cells/microl) separately in patients with baseline VL or = 100,000 copies/ml, the virological efficacy of EFV was similar to that of NVP (0.90) and LPV/r (0.97) and better than that of NFV (0.62), ABC (0.75) and IDV/r (0.78). The immunological results found in these patients were similar to those observed in patients with baseline VL < 100,000 copies/ml. CONCLUSIONS: For first-line therapy, in this observational setting, EFV, LPV/r and NVP, when added to the combivir backbone, were more likely to drive viral load < 500 copies/ml. LPV/r showed the best immunological effectiveness

Transmitted drug resistance in French HIV-2-infected patients.

International audienceWe report the first transmitted drug resistance survey study in HIV-2-infected patients living in France. The prevalence of transmitted drug resistance was 5.0% (95% confidence interval, 0.1-9.9) with mutations detected only in protease, not in reverse transcriptase. In this series, 10% of patients displayed X4/dual-mixed viruses. These findings classified the rate of transmitted drug resistance in the HIV-2 French Cohort as low prevalence

In Vitro Phenotypic Susceptibility of Human Immunodeficiency Virus Type 2 Clinical Isolates to Protease Inhibitors▿

We determine phenotypic susceptibility of human immunodeficiency virus type 2 (HIV-2) isolates to amprenavir, atazanavir, darunavir, indinavir, lopinavir, nelfinavir, saquinavir, and tipranavir. Saquinavir, lopinavir, and darunavir are potent against wild-type HIV-2 isolates and should be preferred as first-line options for HIV-2-infected patients. Other protease inhibitors are less active against HIV-2 than against HIV-1