Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Chicago, IL 60611, United States.
College of Holy Cross, 1 College Street, Worcester, MA 01610, United States.
J Clin Virol. 2014 Mar;59(3):172-6. doi: 10.1016/j.jcv.2013.11.012. Epub 2013 Dec 5.
Rapid HIV test devices are widely used throughout the world and are important as diagnostic tools with relatively high sensitivity and specificity. Loss of HIV specific antibodies in late-stage AIDS patients has previously been reported in patients with advanced disease (i.e., AIDS).
To study rate of antibody loss that may lead to false negative HIV-antibodies results in children and adolescents who received long term antiretroviral (ARV) treatment with persistently undetectable viral loads.
Five FDA approved rapid HIV test kits including Trinity Uni-Gold Recombigen HIV-1, OraQuick Advance HIV-1/2, Reveal G3 HIV-1, Clearview STAT-PAK HIV-1/2, and Clearview COMPLETE HIV-1/2 were used to test 98 stored samples from 27 patients. Samples were tested at baseline and at least twice in 6-14 years post initiation of ARV treatment and full viral load suppression.
Of the 403 tests, 43 (10.7%) were found to be false-negative using rapid HIV kits. Loss of positivity was correlated with decrease of HIV antibody titer.
There is a slow but persistent loss of HIV specific antibodies in highly suppressed HIV infected children and adolescents that may lead to false-negative results in rapid HIV antibody tests. The temporal loss of signal is dependent on the baseline level of antibodies and the type of HIV rapid test kit used.
快速 HIV 检测设备在全球范围内广泛使用，作为具有相对较高灵敏度和特异性的诊断工具非常重要。先前在晚期疾病（即艾滋病）患者中报告了晚期艾滋病患者 HIV 特异性抗体丢失的情况。
研究可能导致接受长期抗逆转录病毒（ARV）治疗且病毒载量持续无法检测到的儿童和青少年的 HIV 抗体假阴性结果的抗体丢失率。
使用了五种获得 FDA 批准的快速 HIV 检测试剂盒，包括 Trinity Uni-Gold Recombigen HIV-1、OraQuick Advance HIV-1/2、Reveal G3 HIV-1、Clearview STAT-PAK HIV-1/2 和 Clearview COMPLETE HIV-1/2，来检测 27 名患者的 98 个存储样本。在开始 ARV 治疗和完全病毒载量抑制后 6-14 年内，在基线和至少两次时对样本进行了检测。
在 403 次检测中，有 43 次（10.7%）使用快速 HIV 试剂盒检测结果为假阴性。阳性结果的丧失与 HIV 抗体滴度的下降相关。
在高度抑制的 HIV 感染儿童和青少年中，HIV 特异性抗体的缓慢但持续丢失可能导致快速 HIV 抗体检测出现假阴性结果。信号的暂时丧失取决于抗体的基线水平和使用的 HIV 快速检测试剂盒的类型。
