title: Antibody maturation and viral diversification in HIV-infected women.
abstract: BACKGROUND
  The Post-exposure Prophylaxis in Infants (PEPI)-Malawi trial evaluated infant antiretroviral regimens for prevention of post-natal HIV transmission. A multi-assay algorithm (MAA) that includes the BED capture immunoassay, an avidity assay, CD4 cell count, and viral load was used to identify women who were vs. were not recently infected at the time of enrollment (MAA recent, N = 73; MAA non-recent, N = 2,488); a subset of the women in the MAA non-recent group known to have been HIV infected for at least 2 years before enrollment (known non-recent, N = 54). Antibody maturation and viral diversification were examined in these women.
  
  
  METHODS
  Samples collected at enrollment (N = 2,561) and 12-24 months later (N = 1,306) were available for serologic analysis using the BED and avidity assays. A subset of those samples was used for analysis of viral diversity, which was performed using a high resolution melting (HRM) diversity assay. Viral diversity analysis was performed using all available samples from women in the MAA recent group (61 enrollment samples, 38 follow-up samples) and the known non-recent group (43 enrollment samples, 22 follow-up samples). Diversity data from PEPI-Malawi were also compared to similar data from 169 adults in the United States (US) with known recent infection (N = 102) and known non-recent infection (N = 67).
  
  
  RESULTS
  In PEPI-Malawi, results from the BED and avidity assays increased over time in the MAA recent group, but did not change significantly in the MAA non-recent group. At enrollment, HIV diversity was lower in the MAA recent group than in the known non-recent group. HRM diversity assay results from women in PEPI-Malawi were similar to those from adults in the US with known duration of HIV infection.
  
  
  CONCLUSIONS
  Antibody maturation and HIV diversification patterns in African women provide additional support for use of the MAA to identify populations with recent HIV infection.
authors: Department of Pathology, Johns Hopkins Univ. School of Medicine, Baltimore, Maryland, United States of America.
authors: Maria M
authors: MM
authors: James
authors: Oliver
authors: O
authors: Laeyendecker
authors: Jin
authors: J
authors: Sun
authors: Donald R
authors: DR
authors: Hoover
authors: Caroline E
authors: CE
authors: Mullis
authors: Matthew M
authors: MM
authors: Cousins
authors: Thomas
authors: T
authors: Coates
authors: Richard D
authors: RD
authors: Moore
authors: Gabor D
authors: GD
authors: Kelen
authors: Mary Glenn
authors: MG
authors: Fowler
authors: Johnstone J
authors: JJ
authors: Kumwenda
authors: Lynne M
authors: LM
authors: Mofenson
authors: Newton I
authors: NI
authors: Kumwenda
authors: Taha E
authors: TE
authors: Taha
authors: Susan H
authors: SH
authors: Eshleman
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use; D000915:Antibody Affinity / Q000187:drug effects / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D014644:Genetic Variation / Q000187:drug effects; D015483:HIV Antibodies / Q000276:immunology*; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics* / Q000276:immunology*; D006801:Humans; D007118:Immunoassay; D008295:Malawi; D009691:Nucleic Acid Denaturation / Q000187:drug effects; D056990:Post-Exposure Prophylaxis; D014481:United States
chemical_list: D019380:Anti-HIV Agents; D015483:HIV Antibodies