Researchers identify less expensive HIV progression test as effective as current tests in use

October 16, 2002

Researchers at the Johns Hopkins University Bloomberg School of Public Health and the University of Zurich, Switzerland, have identified a test for monitoring the progression of HIV in the early stages of the disease, which is less expensive than current tests used to monitor the progression of HIV. The test, called HIV-1 protein 24 (p24) antigen, predicts disease progression as well as CD4 lymphocyte count and HIV-1 RNA viral load, which are currently used to determine when patients should start antiviral drug therapy to prevent AIDS. The study, "Heat-Denatured Human Immunodeficiency Virus Type 1 Protein 24 Antigen: Prognostic Value in Adults with Early-Stage Disease," appears in the Oct. 15 issue of The Journal of Infectious Diseases.

Timothy R. Sterling, MD, a study co-author and assistant professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health said, "The test could be used to determine when to initiate antiretroviral therapy in HIV-infected persons. And because it costs much less than both CD4 lymphocyte count and HIV-1 RNA viral load, the heat-denatured p24 antigen test could be of particular benefit in developing countries, where the burden of HIV infection is great."

According to Dr. Sterling, CD4 lymphocytes and HIV-1 RNA are excellent predictors of disease progression and response to therapy and are used to determine when to initiate antiretroviral therapy. However, the current tests to monitor CD4 lymphocytes and HIV-1 RNA are expensive. The heat-denatured assay separates antigen-antibody complexes and increases the detection of p24 antigen in patients during the early-stages of the disease.

"P24 antigen is a protein in HIV. The test is administered by drawing blood from a patient, heating the plasma, and then measuring the amount of p24 antigen found in the sample. Higher levels of p24 indicates a greater risk of disease progression," explained Dr. Sterling. The authors found that a p24 level of 5 pg/ml was comparable to a CD4 lymphocyte count of 350 cells/mm3 or a viral load of 30,000 copies/ml (b-DNA).

The 494 participants in the study were injection drug users enrolled in a longitudinal cohort study. Blood samples were obtained and analyzed to quantify T-cell subsets; HIV-1 RNA and p24 antigen were quantified in specimens that had been frozen after collection. Semiannual follow-up interviews were also held with participants during the 5-year study.

Using Johns Hopkins Hospital prices, researchers found that conducting a CD4 lymphocyte count is $88; a HIV-1 RNA level is $152. The total cost of a p24 antigen test is approximately $20 when used qualitatively and $30 when used quantitatively. Because of the frequency with which monitoring must be performed to assess disease progression and response to therapy, researchers said they believe the heat-denatured p24 antigen test would be much more affordable than the currently available tests. In addition, they said the p24 antigen assay is readily automated, easy to perform, and storage is less demanding than that required for other tests.

Sterling said, "The heat-denatured p24 antigen test was comparable with that of the HIV-1 RNA and CD4 lymphocytes. In addition to its low cost, it could be used either alone, or in conjunction with the other tests. It would be very useful in making decisions regarding the initiation of antiretroviral therapy, particularly in resource-poor settings."
-end-
Co-Authors of the study were Donald R. Hoover, Jacquie Astemborski, David Vlahov, John G. Bartlett, and Jorg Schupbach.

The study was funded by the Swiss Federal Office of Public Health, Swiss Human Immunodeficiency Virus Cohort Study/Swiss National Science Foundation, National Institute on Drug Abuse, and National Institute of Allergy and Infectious Diseases.

Link to the Johns Hopkins Bloomberg School of Public Health at www.jhsph.edu.

Johns Hopkins University Bloomberg School of Public Health

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.