Detection of p24 antigen with and without immune complex dissociation for longitudinal monitoring of human immunodeficiency virus type 1 infection.
Sequential specimens obtained from 87 multicenter AIDS cohort study participants were tested by three p24 antigen tests. They included a polyclonal enzyme immunoassay (EIA), a monoclonal EIA, and a monoclonal EIA after immune complex dissociation (ICD) of specimens. Subjects were grouped into two categories defined by real-time testing with the polyclonal EIA: 39 had become positive for p24 antigen (antigen converters) during follow-up, and 48 had progressed to AIDS without detectable antigenemia. Twenty-four (61%) antigen converters were positive by ICD-monoclonal EIA about 1 year earlier than by monoclonal EIA. In contrast, only 12 (25%) patients who progressed to AIDS without detectable antigenemia became positive by ICD-p24 EIA before developing AIDS. Thus, the main benefit of ICD treatment may be to detect p24 antigenemia approximately 1 year before the regular assay rather than to identify additional antigenemic people. Quantitative plasma RNA levels were also determined in longitudinal samples from 20 antigen converters and 7 men who developed AIDS without antigenemia. Although mean human immunodeficiency virus type 1 RNA levels were higher in antigen-positive than in antigen-negative samples (P = 0.002), more than half (11 of 20) of the antigen converters had no measurable change in human immunodeficiency virus type 1 RNA associated with change to antigen positivity.
Henrard
D R
DR
Abbott Laboratories, North Chicago, Illinois 60064.
Wu
S
S
Phillips
J
J
Wiesner
D
D
Phair
J
J
D000163:Acquired Immunodeficiency Syndrome / Q000209:etiology / Q000276:immunology; D000936:Antigen-Antibody Complex; D015331:Cohort Studies; D016655:HIV Core Protein p24 / Q000097:blood*; D015658:HIV Infections / Q000145:classification / Q000276:immunology*; D006679:HIV Seropositivity / Q000276:immunology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007124:Immunoenzyme Techniques; D008137:Longitudinal Studies; D008297:Male; D015166:Monitoring, Immunologic; D015337:Multicenter Studies as Topic; D012367:RNA, Viral / Q000097:blood; D012680:Sensitivity and Specificity; D013997:Time Factors
D000936:Antigen-Antibody Complex; D016655:HIV Core Protein p24; D012367:RNA, Viral