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AIDS Res Hum Retroviruses. 2017 Sep;33(9):902-904. doi: 10.1089/AID.2016.0319. Epub 2017 May 24.

Short Communication: Heightened HIV Antibody Responses in Postpartum Women as Exemplified by Recent Infection Assays: Implications for Incidence Estimates.

Author information

1
1 The South African DST/NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), University of Stellenbosch , Stellenbosch, South Africa .
2
2 Zvitambo Institute for Maternal and Child Health Research , Harare, Zimbabwe .
3
3 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia .
4
4 Division of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia .
5
5 Division of Global HIV and TB, Centers for Disease Control and Prevention , Harare, Zimbabwe .

Abstract

Laboratory assays that identify recent HIV infections are important for assessing impacts of interventions aimed at reducing HIV incidence. Kinetics of HIV humoral responses can vary with inherent assay properties, and between HIV subtypes, populations, and physiological states. They are important in determining mean duration of recent infection (MDRI) for antibody-based assays for detecting recent HIV infections. We determined MDRIs for multi-subtype peptide representing subtypes B, E and D (BED)-capture enzyme immunoassay, limiting antigen (LAg), and Bio-Rad Avidity Incidence (BRAI) assays for 101 seroconverting postpartum women, recruited in Harare from 1997 to 2000 during the Zimbabwe Vitamin A for Mothers and Babies trial, comparing them against published MDRIs estimated from seroconverting cases in the general population. We also compared MDRIs for women who seroconverted either during the first 9 months, or at later stages, postpartum. At cutoffs (C) of 0.8 for BED, 1.5 for LAg, and 40% for BRAI, estimated MDRIs for postpartum mothers were 192, 104, and 144 days, 33%, 32%, and 52% lower than published estimates of 287, 152 and 298 days, respectively, for clade C samples from general populations. Point estimates of MDRI values were 7%-19% shorter for women who seroconverted in the first 9 months postpartum than for those seroconverting later. MDRI values for three HIV incidence biomarkers are longer in the general population than among postpartum women, particularly those who recently gave birth, consistent with heightened immunological activation soon after birth. Our results provide a caution that MDRI may vary significantly between subjects in different physiological states.

KEYWORDS:

BRAI; HIV; LAg; MDRI; recent infection

PMID:
28443672
PMCID:
PMC5745575
DOI:
10.1089/AID.2016.0319
[Indexed for MEDLINE]
Free PMC Article

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