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Review
. 2024 Jun 14;229(6):1919-1925.
doi: 10.1093/infdis/jiae113.

HIV Diagnostics and Vaccines: It Takes Two to Tango

Will Colón  1 , Valérie Oriol-Mathieu  2 , John Hural  3 , Lucy Hattingh  4 , Ferdinard Adungo  5 , Ole Lagatie  1 , Ludo Lavreys  2 , Mary Allen  6 , Omu Anzala  7 , Nicole Espy  3 , Katrien Fransen  8 , Patricia J Garcia  9 , Milton Maciel Jr  6 , Maurine Murtagh  10 , Sheila A Peel  11 , Rosanna W Peeling  12 , Litjen L J Tan  13 , Mitchell Warren  14 , Maria Grazia Pau  2 , Patricia M D'Souza  6
Affiliations
Review

HIV Diagnostics and Vaccines: It Takes Two to Tango

Will Colón et al. J Infect Dis. .

Abstract

Current serologic tests for HIV screening and confirmation of infection present challenges to the adoption of HIV vaccines. The detection of vaccine-induced HIV-1 antibodies in the absence of HIV-1 infection, referred to as vaccine-induced seropositivity/seroreactivity, confounds the interpretation of test results, causing misclassification of HIV-1 status with potential affiliated stigmatization. For HIV vaccines to be widely adopted with high community confidence and uptake, tests are needed that are agnostic to the vaccination status of tested individuals (ie, positive only for true HIV-1 infection). Successful development and deployment of such tests will require HIV vaccine developers to work in concert with diagnostic developers. Such tests will need to match today's high-performance standards (accuracy, cost-effectiveness, simplicity) for use in vaccinated and unvaccinated populations, especially in low- and middle-income countries with high HIV burden. Herein, we discuss the challenges and strategies for developing modified serologic HIV tests for concurrent deployment with HIV vaccines.

Keywords: HIV; antibodies; diagnostics; vaccine; vaccine-induced seropositivity/seroreactivity.

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Conflict of interest statement

Potential conflicts of interest. W. C. and O. L. are former and current employees of Janssen Pharmaceutica N.V., respectively, and V. O. M. and M. G. P. are current employees of Janssen Vaccines and Prevention B.V. Both are Johnson & Johnson companies, and the authors may own stock or stock options in them. L. L. is a consultant for Janssen Pharmaceutica N.V. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Key factors for successful development and adoption of modified HIV diagnostic tests in a vaccinated world. LMICs, low- and middle-income countries; NAATs, nucleic acid amplification tests; NGOs, nongovernmental organizations; VISP/R, vaccine-induced seropositivity/seroreactivity; WHO, World Health Organization.
See this image and copyright information in PMC

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