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1993-01-09
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─ Area: AIDS-HIV - R ─────────────────────────────────────────────────────────
Msg#: 506 Date: 01-08-93 04:43
From: Billi Goldberg Read: Yes Replied: No
To: All Mark:
Subj: (10) CDC SUMMARY 1/6/93
──────────────────────────────────────────────────────────────────────────────
-=> Quoting Billi Goldberg to All <=-
BG> "Reliability of Western Blotting for the Confirmation of HIV-1
BG> Seroconversion" Lancet (12/19-26/92) Vol. 340, No. 8834/8835, P. 1541
BG> (Simon, Francois et al.)
BG> Western blotting (WB) lacks sensitivity during seroconversion and
BG> should no longer be considered the gold standard for serological
BG> diagnosis of HIV infection, write Francois Simon and colleagues of
BG> the Hopital Bichat-Claude Bernard in Paris, France. The researchers
BG> followed the timing of seroconversion in 27 patients between April
BG> 1990 and October 1992. In eight of these, all of whom had symptoms,
BG> the first available serum samples were negative by WB, but contained
BG> neutralizable p24 antigen or were repeatedly positive with at least
BG> one EIA test, or both. A total of 10 of the 11 samples were positive
BG> for p24 antigen; the other sample remained negative after acid
BG> dissociation. Later sequential samples from these eight patients
BG> showed a characteristic seroconversion pattern in WB. Among the two
BG> first generation EIA tests, neither was positive, and the second-
BG> generation tests based on recombinant antigens were positive in only
BG> one patient. Both second generation tests based on synthetic peptides
BG> were positive in three patients. The third generation tests were
BG> highly sensitive since both were positive for 6 of the 11 samples,
BG> and gave reproducible overflow reactivity in 2 of these. Three
BG> samples remained negative with all EIA tests; the only marker of
BG> infection was serum p24 antigen; the EIA antibodies tests became
BG> positive only after 1, 4, and 5 days. The detection and confirmation
BG> of HIV-1 infection should be based on the use of several EIA tests,
BG> together with the detection of p24 antigen during the initial phase
BG> of primary HIV-1 infection, the researchers conclude.
BG> -!-
BG> * The GrapeVine/Ferret Face BBS * NLR,ARK * 501-753-8121 DS *
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