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Journal of Clinical Microbiology, February 2007, p. 415-420, Vol. 45, No. 2
0095-1137/07/$08.00+0     doi:10.1128/JCM.01879-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Human Immunodeficiency Virus (HIV) Antibody Avidity Testing To Identify Recent Infection in Newly Diagnosed HIV Type 1 (HIV-1)-Seropositive Persons Infected with Diverse HIV-1 Subtypes{triangledown}

A. Chawla,1 G. Murphy,2 C. Donnelly,1 C. L. Booth,1 M. Johnson,3 J. V. Parry,2 A. Phillips,4 and A. M. Geretti1*

Department of Virology,1 Department of HIV and Thoracic Medicine,3 Department of Primary Care and Population Sciences, Royal Free Hospital and Royal Free and University College Medical School, London, United Kingdom,4 Health Protection Agency, Colindale, United Kingdom2

Received 9 September 2006/ Returned for modification 15 November 2006/ Accepted 22 November 2006

A guanidine-based antibody avidity assay for the identification of recently acquired human immunodeficiency virus type 1 (HIV-1) infection was evaluated. The kinetics of maturation of antibody avidity were determined prospectively in 23 persons undergoing acute seroconversion followed for up to 1,075 days. Avidity indices (AI) of ≤0.75 and ≤0.80 reproducibly identified seroconversion within the previous 125 (95% confidence interval [CI], 85 to 164) and 142 (95% CI, 101 to 183) days, respectively. To validate the assay, 432 serum samples from newly diagnosed patients were tested by both the avidity assay and the detuned assay. Results were highly concordant (kappa value for agreement, 0.85). The avidity assay was subsequently used to screen 134 consecutive newly diagnosed patients, including 55/134 (41%) infected with non-B subtypes (A, C, D, G, CRF01, CRF02, CRF06, CRF13, and CRF16). In this cohort, 25/79 (32%) persons with the B subtype and 7/55 (13%) with non-B subtypes showed an AI of ≤0.75, and there were 16/25 (64%) and 3/7 (43%) persons, respectively, with a documented history of acute seroconversion illness within the predicted seroconversion interval. An AI of ≤0.75 was also observed for four patients (three with the B subtype and one with a non-B subtype) who presented with AIDS-defining conditions. In multivariate analysis, an AI of ≤0.75 was associated with younger age, higher HIV-1 plasma RNA load, and being born in the United Kingdom or Ireland rather than in Africa but not with gender, ethnicity, risk group, HIV-1 subtype, or CD4 counts. In conclusion, HIV antibody avidity testing provides a reliable method for identifying recently acquired HIV-1 infection. Results are affected by advanced disease and should therefore be interpreted in the context of other clinical parameters.

* Corresponding author. Mailing address: Department of Virology, Royal Free Hospital, Pond Street, London NW3 2QG, United Kingdom. Phone: 44 20 77940500. Fax: 44 20 78302854. E-mail: a.geretti{at}medsch.ucl.ac.uk.

{triangledown} Published ahead of print on 6 December 2006.

Journal of Clinical Microbiology, February 2007, p. 415-420, Vol. 45, No. 2
0095-1137/07/$08.00+0     doi:10.1128/JCM.01879-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

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