title: A Cytokine Pattern That Differentiates Preseroconversion From Postseroconversion Phases of Primary HIV Infection.
abstract: BACKGROUND
  During acute HIV infection, HIV actively replicates but seroconversion has not yet occurred. Primary HIV infection (PHI) is characterized by a transient nonspecific febrile illness, a massive inflammatory response, and the progressive appearance of anti-HIV-specific antibodies. In this study, we have identified patterns of inflammatory biomarkers associated with the innate immunological reaction before completion of a full humoral response.
  
  
  METHODS
  A symptom-based screening was used to identify acute HIV infection in the Manhiça District Hospital in Mozambique. Plasma levels of biomarkers were determined by Luminex and enzyme-linked immunosorbent assay. Anti-HIV antibodies were analyzed by flow cytometry and Western blot. Statistical analyses used random forest and logistic regression models.
  
  
  RESULTS
  Of 3116 rapid test seronegative or indeterminate individuals, 85 (2.7%) had positive plasma HIV viral load and were enrolled as PHI, of which n = 45 (52.9%), n = 8 (9.4%), n = 12 (14.1%), and n = 20 (23.5%) were classified as Fiebig I-III, IV, V, and VI stages, respectively, by Western blot. Comparison of individuals at early (Fiebig I-IV) and late (Fiebig V-VI) immune stages identified significant differences in the expression level of plasma B-cell activating factor , monocyte chemotactic protein-1, sCD163, and monokine induced by interferon (IFN-γ). This cytokine signature classified patients in the preseroconversion phase with a sensitivity of 92.5% and a specificity of 81.2% CONCLUSIONS:: Identification of a cytokine signature specific for the preseroconversion stage of PHI may help to understand the earliest HIV pathogenic events and identify new potential targets for immunotherapy aimed at modulating the cytokine response to HIV infection.
authors.affiliation: *AIDS Research Institute-IrsiCaixa, Hospital Germans Trias i Pujol, Badalona, Spain; †ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; ‡Institut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autonoma de Barcelona, Badalona, Spain; §School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; ‖Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; and ¶Universitat de Vic-Universitat Central de Catalunya, Barcelona, Spain.
authors.forename: Lucia
authors.initials: L
authors.lastname: Pastor
authors.forename: Erica
authors.initials: E
authors.lastname: Parker
authors.forename: Jorge
authors.initials: J
authors.lastname: Carrillo
authors.forename: Victor
authors.initials: V
authors.lastname: Urrea
authors.forename: Laura
authors.initials: L
authors.lastname: Fuente-Soro
authors.forename: Durval
authors.initials: D
authors.lastname: Respeito
authors.forename: Chenjerai
authors.initials: C
authors.lastname: Jairoce
authors.forename: Inacio
authors.initials: I
authors.lastname: Mandomando
authors.forename: Julià
authors.initials: J
authors.lastname: Blanco
authors.forename: Denise
authors.initials: D
authors.lastname: Naniche
mesh_terms: D000328:Adult; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006679:HIV Seropositivity / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007113:Immunity, Innate; D008297:Male; D018448:Models, Immunological; D009073:Mozambique; D011446:Prospective Studies; D019562:Viral Load; D014766:Viremia; D055815:Young Adult
chemical_list: D016207:Cytokines