Laboratory diagnosis of dual HIV-1/HIV-2 infection in Ghanaian patients.
OBJECTIVE
To determine the true prevalence of HIV dual infections in a previously characterised HIV seropositive patient group due to inconsistencies between different diagnostic methods.


METHODS
A cross-sectional study of an HIV seropositive group with different diagnostic methods.


METHODS
Three hospitals in the Northern, Ashanti and Greater Accra Regions of Ghana.


METHODS
One hundred and forty five HIV infected patients/individuals sampled from June to September 2002.


METHODS
Using serological and molecular methods, the seropositive status of HIV-infected patients, previously determined by a preliminary screening process, was confirmed and discrepancies noted. The data was used to propose a more accurate laboratory diagnosis of HIV dual infections involving HIV-1 and HIV-2. RESULTA: HIV-1 infections were mostly accurately detected, but difficulties were encountered in diagnosing HIV-2 infections. To achieve a positive detection on confirmatory immunoblots, antibody concentration in some samples tested was enhanced by using larger volumes. In other cases, diagnosis of HIV infections by PCR, especially HIV-2, was possible only after increasing the DNA template or MgCl2 concentrations. Such samples would otherwise have been inaccurately scored for HIV infections.


CONCLUSIONS
Based on the results of this study, we propose that the accurate diagnosis of HIV dual infections, especially HIV-2 component, must use an algorithm that involves PCR. Our results however underscore conclusions of a previous study that most dually seroreactive samples are predominantly HIV-1 infections with crossreactivity to HIV-2 antigens.
Noguchi Memorial Institute for Medical Research, S. T. Sackey, PhD, Department of Biochemistry, University of Ghana, Legon Accra, Ghana.
E Y
EY
Bonney
S T
ST
Sackey
J A M
JA
Brandful
D019411:Clinical Laboratory Techniques; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000235:genetics; D005869:Ghana / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis* / Q000821:virology; D015497:HIV-1; D015498:HIV-2; D006801:Humans; D016133:Polymerase Chain Reaction
D004279:DNA, Viral