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Clinical Trial
. 2016 May 25;11(5):e0156023.
doi: 10.1371/journal.pone.0156023. eCollection 2016.

Performance of Bio-Rad and Limiting Antigen Avidity Assays in Detecting Recent HIV Infections Using the Quebec Primary HIV-1 Infection Cohort

Bouchra Serhir  1 , Denis Hamel  2 , Florence Doualla-Bell  1   3 , Jean Pierre Routy  4   5 , Sylvie-Nancy Beaulac  1 , Mario Legault  5 , Micheline Fauvel  1 , Cécile Tremblay  1   5   6 ; Quebec Primary HIV infection study group
Affiliations
Clinical Trial

Performance of Bio-Rad and Limiting Antigen Avidity Assays in Detecting Recent HIV Infections Using the Quebec Primary HIV-1 Infection Cohort

Bouchra Serhir et al. PLoS One. .

Abstract

Background: Accurate and practical biologic tools to estimate HIV incidence is crucial to better monitor the epidemic and evaluate the effectiveness of HIV prevention and treatment programs.

Methods: We evaluated two avidity assays to measure recent HIV infection: the Sedia HIV-1 LAg-Avidity EIA (Sedia Biosciences, Portland) and the Centers for Disease Control and Prevention (CDC)-modified Bio-Rad-Avidity assay (Bio-Rad Laboratories, Mississauga, ON). Longitudinal specimens (n = 473) obtained from 123 treatment-naive seroconverted individuals enrolled in the Primary HIV-1 Infection (PHI) cohort of Quebec were used to determine the average time an individual is considered to be recently infected (mean duration of recent infection; MDRI), for the two avidity assays alone and in combination using a nonparametric survival method analysis. A total of 420 specimens from individuals with established HIV infection (90 individuals from the PHI cohort of Quebec and 330 individuals from the Laboratoire de santé publique du Quebec (LSPQ) serobank) were also tested to investigate false recency rate (FRR).

Results: The CDC-modified Bio-Rad-Avidity gave an estimated MDRI of 234 days (95% CI 220-249) at the avidity index cutoff of 30% while the Sedia-LAg-Avidity assay gave an estimated MDRI of 120 days (95% CI 109-132) at the normalized optical density (ODn) cutoff of 1.5. The FRR among individuals with established HIV infection was 10.2% (7.5%-13.5%) with the CDC-modified Bio-Rad-Avidity assay as compared to 6.0% (3.9%-8.7%) with the Sedia-LAg-Avidity assay. When optimizing a multiassay algorithm (MAA) that includes sequentially the CDC-modified Bio-Rad-Avidity assay then the Sedia-LAg-Avidity assay EIA (avidity index/ODn: 30%/1.7), the MDRI was 136 days (95% CI 123-148) and the FRR, 3.3% (95% CI 1.8-5.6).

Conclusion: Multiassay algorithms that include the CDC-modified Bio-Rad-Avidity assay and the Sedia-LAg-Avidity assay performed better than each avidity assay alone. Such 2-assay algorithm that starts with the CDC-modified Bio-Rad-Avidity assay followed by the Sedia-LAg-Avidity assay allowed a better classification of HIV-1 infections.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. HIV antibody kinetics (up) and box-and-whisker plots showing median of AI measurements at 50 days intervals (bottom) of the all 150 seroconverting individuals of the PHI cohort of Québec (A), the 123 treatment-naive patients of the PHI cohort of Québec (B), the individuals of the PHI cohort of Québec treated between 0 and 400 days post-seroconversion (C), using the CDC-modified Bio-Rad-Avidity assay.
The ‘recent/long-standing’ infection cutoff value is shown by the horizontal dashed line. AI: avidity index.
Fig 2
Fig 2. HIV antibody kinetics (up) and box-and-whisker plots showing median of ODn measurements at 50 days intervals (bottom) of the all 150 seroconverting individuals of the PHI cohort of Québec (A), the 123 treatment-naive patients of the PHI cohort of Québec (B), the individuals of the PHI cohort of Québec treated between 0 and 400 days post-seroconversion (C), using the Sedia-LAg-Avidity assay.
The ‘recent/long-standing’ infection cutoff value is shown by the horizontal dashed line. ODn: normalized optical density.
See this image and copyright information in PMC

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