Quantification of HIV-1 p24 by a highly improved ELISA: an alternative to HIV-1 RNA based treatment monitoring in patients from Abidjan, Côte d'Ivoire.
BACKGROUND
Quantification of HIV-1 RNA remains difficult to implement in Africa. Simple and inexpensive tests for antiretroviral treatment (ART) monitoring are needed.


OBJECTIVE
To evaluate an HIV-1 p24 ELISA, which combines efficient virus disruption, heat-denaturation and signal amplification, in a West African setting.


METHODS
Eighty-six HIV-1 infected patients from Abidjan, Côte d'Ivoire, were tested for p24, HIV-1 RNA, and CD4+ count at baseline, and twice within 8 months after ART initiation.


RESULTS
All patients responded to ART with a minimal HIV-1 RNA drop of 0.5 log(10) at first follow-up. Forty-one (47.7%) then rebounded >0.5 log(10) or persisted above 1000 copies/mL by week 24. The predicted baseline concentration of p24 corresponding to 100,000 copies/mL of HIV-1 RNA, above which ART is recommended, was 4546 fg/mL (95% confidence interval 3148-6566). A prediction model of virologic failure, occurring after an initial response to ART, correctly classified 84% of patients using baseline p24, p24 change on therapy, and achievement of undetectable p24 as explanatory variables. The model and further bootstrap evaluation suggested a good ability to discriminate between sustained or failing virologic response to ART.


CONCLUSIONS
HIV-1 p24 and RNA based-ART monitoring in a low-resource country dominated by HIV-1 CRF02 AG appeared comparable.
Tehe
Andre
A
Projet RETRO-CI, Abidjan, Côte d'Ivoire. andretehe@yahoo.fr
Maurice
Chantal
C
Hanson
Debra L
DL
Borget
Marie Y
MY
Abiola
Nadine
N
Maran
Matthieu
M
Yavo
Daniel
D
Tomasik
Zuzana
Z
Böni
Jürg
J
Schüpbach
Jörg
J
Nkengasong
John N
JN
D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes / Q000821:virology; D007560:Cote d'Ivoire; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D016655:HIV Core Protein p24 / Q000097:blood* / Q000276:immunology; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000097:blood*; D019562:Viral Load
D044966:Anti-Retroviral Agents; D016655:HIV Core Protein p24; D012367:RNA, Viral