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Title: | IP-10 Levels as an Accurate Screening Tool to Detect Acute HIV Infection in Resource-Limited Settings |
Author: | Pastor, Lucía Casellas, Aina Carrillo, Jorge Alonso, Sergi Parker, Erica Fuente Soro, Laura Jairoce, Chenjerai Mandomando, Inácio Blanco, Julià Naniche, Denise |
Keywords: | VIH (Virus) Cribratge HIV (Viruses) Medical screening |
Issue Date: | 14-Aug-2017 |
Publisher: | Nature Publishing Group |
Abstract: | Acute HIV infection (AHI) is the period prior to seroconversion characterized by high viral replication, hyper-transmission potential and commonly, non-specific febrile illness. AHI detection requires HIV-RNA viral load (VL) determination, which has very limited access in low-income countries due to restrictive costs and implementation constraints. We sought to identify a biomarker that could enable AHI diagnosis in scarce-resource settings, and to evaluate the feasibility of its implementation. HIV-seronegative adults presenting at the Manhica District Hospital, Mozambique, with reported-fever were tested for VL. Plasma levels of 49 inflammatory biomarkers from AHI (n = 61) and non-HIV infected outpatients (n = 65) were determined by Luminex and ELISA. IP-10 demonstrated the best predictive power for AHI detection (AUC = 0.88 [95%CI 0.80-0.96]). A cut-off value of IP-10 >/= 161.6 pg/mL provided a sensitivity of 95.5% (95%CI 85.5-99.5) and a specificity of 76.5% (95%CI 62.5-87.2). The implementation of an IP-10 screening test could avert from 21 to 84 new infections and save from US$176,609 to US$533,467 to the health system per 1,000 tested patients. We conclude that IP-10 is an accurate biomarker to screen febrile HIV-seronegative individuals for subsequent AHI diagnosis with VL. Such an algorithm is a cost-effective strategy to prevent disease progression and a substantial number of further HIV infections. |
Note: | Reproducció del document publicat a: http://dx.doi.org/10.1038/s41598-017-08218-0 |
It is part of: | Scientific Reports, 2017, vol. 7, num. 1, p. 8104 |
URI: | http://hdl.handle.net/2445/115803 |
Related resource: | http://dx.doi.org/10.1038/s41598-017-08218-0 |
ISSN: | 2045-2322 |
Appears in Collections: | Articles publicats en revistes (ISGlobal) |
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pastor2017_2663.pdf | 2.85 MB | Adobe PDF | View/Open |
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