title: Acid dissociation increases the sensitivity of p24 antigen detection for the evaluation of antiviral therapy and disease progression in asymptomatic human immunodeficiency virus-infected persons.
abstract: Because the time from primary infection to symptoms in human immunodeficiency virus type 1 (HIV-1) infection is typically 8-10 years, the use of surrogate markers to monitor disease progression and therapeutic efficacy is of interest. An acid dissociation procedure that disrupts the p24 antigen-antibody complexes found in early HIV-1 infection has greatly increased the sensitivity of p24 detection assays. The utility of p24 antigen after acid treatment as a surrogate marker of disease progression and therapeutic effect in asymptomatic HIV-infected subjects receiving zidovudine (AZT) was determined. After acid treatment, the sensitivity of p24 antigen detection increased fivefold. The proportion of subjects who were antigenemic increased over the 48-week follow-up in the placebo group; approximately 50% of subjects who were p24 antigen-positive at entry and who received AZT showed clearance or a greater than 50% reduction in baseline p24 antigen levels at 16 and 32 weeks. Thus, acid treatment of plasma may allow the use of p24 antigen as a marker of disease progression and therapeutic response.
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, MD 21205.
authors.forename: R C
authors.initials: RC
authors.lastname: Bollinger
authors.forename: R L
authors.initials: RL
authors.lastname: Kline
authors.forename: H L
authors.initials: HL
authors.lastname: Francis
authors.forename: M W
authors.initials: MW
authors.lastname: Moss
authors.forename: J G
authors.initials: JG
authors.lastname: Bartlett
authors.forename: T C
authors.initials: TC
authors.lastname: Quinn
mesh_terms: D015331:Cohort Studies; D004311:Double-Blind Method; D016903:Drug Monitoring; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D016655:HIV Core Protein p24 / Q000097:blood*; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D006851:Hydrochloric Acid / Q000494:pharmacology*; D006863:Hydrogen-Ion Concentration; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D016655:HIV Core Protein p24; D015215:Zidovudine; D006851:Hydrochloric Acid