Hayashida Tsunefusa, Gatanaga Hiroyuki, Tanuma Junko, Oka Shinichi
AIDS Clinical Center, International Medical Center of Japan, Tokyo, Japan.
AIDS Res Hum Retroviruses. 2008 Mar;24(3):495-8. doi: 10.1089/aid.2007.0150.
The IgG-capture BED-enzyme immunoassay (BED-CEIA) is used widely at present to detect recent HIV-1 seroconversion. However, antibody levels and antibody kinetics are impacted by HIV-1 load and antiretroviral treatment, which may have a significant effect on the assay results. In this study, we analyzed serial samples from 11 patients with recent infection, including four patients treated by structured treatment interruption (STI), and compared the results with those of 10 untreated and 7 treated patients with chronic infection. The BED-CEIA missidentified one long-term nonprogressor hemophiliac with an extremely low HIV-1 load and five patients with chronic infection who received antiretroviral treatment. We also found that the ODn values increased slowly in patients with recent infection and low HIV-1 loads and that the ODn values fluctuated in parallel with HIV-1 load during STI. Our data indicate that the results of BED-CEIA are influenced by HIV-1 load and antiretroviral treatment. Care should be taken when interpreting the results of BED-CEIA, especially in individuals with low HIV-1 loads. Those on antiretroviral treatment should be excluded from BED-CEIA testing to improve the predictive value of detecting recent infections.
目前，IgG捕获BED酶免疫测定法（BED-CEIA）被广泛用于检测近期HIV-1血清转化。然而，抗体水平和抗体动力学受HIV-1载量和抗逆转录病毒治疗的影响，这可能对检测结果产生显著影响。在本研究中，我们分析了11例近期感染患者的系列样本，其中包括4例接受结构化治疗中断（STI）的患者，并将结果与10例未治疗的慢性感染患者和7例接受治疗的慢性感染患者的结果进行比较。BED-CEIA将1例HIV-1载量极低的长期不进展血友病患者以及5例接受抗逆转录病毒治疗的慢性感染患者误判。我们还发现，近期感染且HIV-1载量低的患者ODn值上升缓慢，且在STI期间ODn值随HIV-1载量平行波动。我们的数据表明，BED-CEIA的结果受HIV-1载量和抗逆转录病毒治疗的影响。在解释BED-CEIA结果时应谨慎，尤其是对于HIV-1载量低的个体。接受抗逆转录病毒治疗的患者应排除在BED-CEIA检测之外，以提高检测近期感染的预测价值。
