XIX International AIDS Conference


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LBPE28 - Poster Exhibition

A novel lateral flow test for the simultaneous detection of recent or long-term HIV-1 infection

Presented by Timothy Granade (United States).

T. Granade1, B. Parekh2, K. Ambrose1, M. Owen1

1Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, United States, 2Centers for Disease Control and Prevention, Division of Global HIV/AIDS, Conyers, United States

Background: The monitoring of incident HIV infections is important for targeting prevention efforts. Current assays for detecting recent HIV infections are laboratory-based which limit their application in resource-poor areas with limited laboratory capability. This study evaluated a rapid, lateral-flow HIV-1 incidence-prevalence (I-P) test for distinguishing recent from long-term infections.
Methods: The rapid I-P test uses an eight-branched gp41-peptide applied at a high concentration for diagnostic detection of HIV antibodies and a multi-subtype recombinant gp41-protein applied at a low concentration to distinguish recent from long-term HIV infections. Long-term infections are detected by both antigens while antibodies present in recent HIV infections are detected only by the high concentration line. Protein A is used as an internal assay control. The evaluation panel included commercial seroconversion panels (n=23; total specimens = 109), a long-term longitudinal panel with specimens HIV antibody-positive for > 365 days (n=54, total specimens = 568), and seroconversion panels collected over a 24 month period (n=8, total specimens = 79). Rapid I-P data were compared to the commercial BED HIV-1 incidence assay and in-house incidence assays.
Results: All 53 HIV-1 positive members of the commercial seroconversion panels collected within 28 days of seroconversion were classified as recent HIV-1 infections by the rapid I-P assay. The rapid I-P test classified 557 of the 568 (98.19%) long-term longitudinal panel specimens as long-term infections. Ten false- recent specimens were in late stage AIDS. Specimens collected < 183 days after seroconversion (n=30) were classified as recent infections, and specimens collected ≥ 183 days after seroconversion were classified as long-term infections (n=49).
Conclusions: The rapid I-P test may be applicable in global settings to identify high incidence areas for HIV prevention efforts. More work is needed to compare rapid I-P test results with other tests for recent HIV infection and to establish the mean recency period.

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