Mafuyeka Rendani T, Webber Lynne M, Becker Piet, Mayaphi Simnikiwe H
Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Department of Virology, Tshwane Academic division, National Health Laboratory, Pretoria, South Africa.
South Afr J HIV Med. 2021 Mar 12;22(1):1185. doi: 10.4102/sajhivmed.v22i1.1185. eCollection 2021.
The human immunodeficiency virus type-2 (HIV-2) prevalence in South Africa (SA) is unknown, however, sporadic cases have been reported. Human immunodeficiency virus -1 and 2 differentiation is not part of most South African public laboratories' testing algorithm. Human immunodeficiency virus -2 diagnosis using serology assays may be complicated by HIV-1 and HIV-2 antibody cross-reactivity.
To determine the proportion of HIV-2 infections in specimens that tested HIV-1/2 positive at a public laboratory in Tshwane.
A total of 480 specimens that were previously tested with fourth generation ELISA platforms (Modular E170 [Roche, Switzerland] and Architect i2000 [Abbott, Germany]) were randomly selected. Human immunodeficiency virus -1 and 2 antibody differentiation testing was carried out using the Multispot HIV-1/2 rapid assay (Bio-Rad Laboratories, USA). An in-house nested HIV-2 PCR assay targeting the 5'-long terminal repeats (5'-LTR) region was evaluated and used as a confirmatory test.
The study tested 480 HIV-1/2 seropositive patients and their mean age was 36.7 years (range 3-82 years). Of the 480 patients, 292 (60.8%) were female, 182 (37.9%) were male and 6 (1.3%) were not specified. Human immunodeficiency virus differentiation results were as follows: 466 (97.1%) were positive for only HIV-1 antibodies, 11 (2.3%) [95%CI: (0.98%; 3.74%)] were positive for both HIV-1 and HIV-2 antibodies, 3 (0.6%) were negative for both antibodies and none were positive for only HIV-2 antibodies. Of the 11 specimens with both HIV-1 and HIV-2 antibodies, seven had sufficient volume for confirmatory testing and were all negative on the in-house HIV-2 PCR assay.
The multispot HIV-1/2 rapid assay demonstrated cross-reactivity between HIV-1 and HIV-2 antibodies. Human immunodeficiency virus -2 infections were not detected.
南非人类免疫缺陷病毒2型（HIV-2）的流行情况未知，但已有散发病例的报道。HIV-1和HIV-2的区分并非大多数南非公共实验室检测流程的一部分。使用血清学检测方法诊断HIV-2可能会因HIV-1和HIV-2抗体的交叉反应而变得复杂。
确定在茨瓦内一家公共实验室检测HIV-1/2呈阳性的标本中HIV-2感染的比例。
随机选择480份先前使用第四代ELISA平台（瑞士罗氏公司的Modular E170和德国雅培公司的Architect i2000）检测过的标本。使用美国伯乐公司的Multispot HIV-1/2快速检测法进行HIV-1和HIV-2抗体区分检测。评估并使用一种针对5'-长末端重复序列（5'-LTR）区域的内部巢式HIV-2 PCR检测法作为确证试验。
该研究检测了480名HIV-1/2血清学阳性患者，他们的平均年龄为36.7岁（范围为3至82岁）。在这480名患者中，292名（60.8%）为女性，182名（37.9%）为男性，6名（1.3%）未注明性别。HIV区分结果如下：466名（97.1%）仅HIV-1抗体呈阳性，11名（2.3%）[95%置信区间：（0.98%；3.74%）]HIV-1和HIV-2抗体均呈阳性，3名（0.6%）两种抗体均呈阴性，没有仅HIV-2抗体呈阳性的情况。在11份HIV-1和HIV-2抗体均呈阳性的标本中，7份有足够的量进行确证检测，且在内部HIV-2 PCR检测中均为阴性。
Multispot HIV-1/2快速检测法显示HIV-1和HIV-2抗体之间存在交叉反应。未检测到HIV-2感染。
