title: Short Communication: The Impact of Viral Suppression and Viral Breakthrough on Limited-Antigen Avidity Assay Results in Individuals with Clade B HIV Infection.
abstract: We analyzed the impact of HIV viral load on the performance of a limiting antigen avidity enzyme immunoassay (LAg-Avidity assay) and determined if this assay could be used to identify viral breakthrough. Three groups of samples were tested: (1) 18 individuals (30 samples) previously identified as elite suppressors; (2) 18 individuals (72 samples) who were continually suppressed on antiretroviral treatment (ART) with 1 sample before and 2-6 samples (one/year) after ART initiation; and (3) 20 individuals (179 samples) on ART who had evidence of viral breakthrough (>400 copies/ml) with subsequent viral suppression. Elite suppressors had the lowest LAg-Avidity assay values. Among those who were continually suppressed on ART, 83% (15/18) had LAg-Avidity assay values that decreased over time. Although the LAg-Avidity assay on a single sample cannot identify when a viral breakthrough occurs, paired longitudinal samples could identify viral breakthrough (sensitivity: 65%, specificity: 84%).
authors.affiliation: 1 Laboratory of Immunoregulation (LIR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH) , Baltimore, Maryland.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Wendel
authors.affiliation: 2 Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Longosz
authors.affiliation: 3 Department of Pathology, Johns Hopkins University School of Medicine , Baltimore, Maryland.
authors.forename: Susan H
authors.initials: SH
authors.lastname: Eshleman
authors.affiliation: 2 Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland.
authors.forename: Joel N
authors.initials: JN
authors.lastname: Blankson
authors.affiliation: 2 Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Moore
authors.affiliation: 2 Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland.
authors.forename: Jeanne C
authors.initials: JC
authors.lastname: Keruly
authors.affiliation: 1 Laboratory of Immunoregulation (LIR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH) , Baltimore, Maryland.|2 Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
authors.affiliation: 1 Laboratory of Immunoregulation (LIR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH) , Baltimore, Maryland.|2 Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Laeyendecker
mesh_terms: D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D015488:HIV Antigens / Q000276:immunology*; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D012680:Sensitivity and Specificity; D015163:Superinfection / Q000175:diagnosis*; D000072230:Sustained Virologic Response; D019562:Viral Load
chemical_list: D015488:HIV Antigens
keywords: ART; HIV; LAg; viral suppression