Long-term highly suppressed HIV-infected children and adolescents with negative rapid HIV tests due to significant antibody loss.
BACKGROUND
Rapid HIV test devices are widely used throughout the world and are important as diagnostic tools with relatively high sensitivity and specificity. Loss of HIV specific antibodies in late-stage AIDS patients has previously been reported in patients with advanced disease (i.e., AIDS).


OBJECTIVE
To study rate of antibody loss that may lead to false negative HIV-antibodies results in children and adolescents who received long term antiretroviral (ARV) treatment with persistently undetectable viral loads.


METHODS
Five FDA approved rapid HIV test kits including Trinity Uni-Gold Recombigen HIV-1, OraQuick Advance HIV-1/2, Reveal G3 HIV-1, Clearview STAT-PAK HIV-1/2, and Clearview COMPLETE HIV-1/2 were used to test 98 stored samples from 27 patients. Samples were tested at baseline and at least twice in 6-14 years post initiation of ARV treatment and full viral load suppression.


RESULTS
Of the 403 tests, 43 (10.7%) were found to be false-negative using rapid HIV kits. Loss of positivity was correlated with decrease of HIV antibody titer.


CONCLUSIONS
There is a slow but persistent loss of HIV specific antibodies in highly suppressed HIV infected children and adolescents that may lead to false-negative results in rapid HIV antibody tests. The temporal loss of signal is dependent on the baseline level of antibodies and the type of HIV rapid test kit used.
Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Chicago, IL 60611, United States.
Moheet
M
Merchant
College of Holy Cross, 1 College Street, Worcester, MA 01610, United States.
Maggie
M
Wright
Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Chicago, IL 60611, United States.
William
W
Kabat
Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Chicago, IL 60611, United States. Electronic address: ryogev@luriechildrens.org.
Ram
R
Yogev
D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D005188:False Negative Reactions; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007124:Immunoenzyme Techniques; D011933:Reagent Kits, Diagnostic; D014773:Virology
D044966:Anti-Retroviral Agents; D015483:HIV Antibodies; D011933:Reagent Kits, Diagnostic
Antibody titer decay; Enzyme immunoassay; False-negative HIV tests; Rapid HIV testing; Undetectable viral loads; Viral suppression