IP-10 Levels as an Accurate Screening Tool to Detect Acute HIV Infection in Resource-Limited Settings

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 countri...

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Autores principales:	Lucía Pastor, Aina Casellas, Jorge Carrillo, Sergi Alonso, Erica Parker, Laura Fuente-Soro, Chenjerai Jairoce, Inacio Mandomando, Julià Blanco, Denise Naniche
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/defa7c564ed94a25b38b022de8d8f3a1
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spelling	oai:doaj.org-article:defa7c564ed94a25b38b022de8d8f3a12021-12-02T12:32:49ZIP-10 Levels as an Accurate Screening Tool to Detect Acute HIV Infection in Resource-Limited Settings10.1038/s41598-017-08218-02045-2322https://doaj.org/article/defa7c564ed94a25b38b022de8d8f3a12017-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-08218-0https://doaj.org/toc/2045-2322Abstract 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 Manhiça 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.Lucía PastorAina CasellasJorge CarrilloSergi AlonsoErica ParkerLaura Fuente-SoroChenjerai JairoceInacio MandomandoJulià BlancoDenise NanicheNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-9 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lucía Pastor Aina Casellas Jorge Carrillo Sergi Alonso Erica Parker Laura Fuente-Soro Chenjerai Jairoce Inacio Mandomando Julià Blanco Denise Naniche IP-10 Levels as an Accurate Screening Tool to Detect Acute HIV Infection in Resource-Limited Settings
description	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 Manhiça 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.
format	article
author	Lucía Pastor Aina Casellas Jorge Carrillo Sergi Alonso Erica Parker Laura Fuente-Soro Chenjerai Jairoce Inacio Mandomando Julià Blanco Denise Naniche
author_facet	Lucía Pastor Aina Casellas Jorge Carrillo Sergi Alonso Erica Parker Laura Fuente-Soro Chenjerai Jairoce Inacio Mandomando Julià Blanco Denise Naniche
author_sort	Lucía Pastor
title	IP-10 Levels as an Accurate Screening Tool to Detect Acute HIV Infection in Resource-Limited Settings
title_short	IP-10 Levels as an Accurate Screening Tool to Detect Acute HIV Infection in Resource-Limited Settings
title_full	IP-10 Levels as an Accurate Screening Tool to Detect Acute HIV Infection in Resource-Limited Settings
title_fullStr	IP-10 Levels as an Accurate Screening Tool to Detect Acute HIV Infection in Resource-Limited Settings
title_full_unstemmed	IP-10 Levels as an Accurate Screening Tool to Detect Acute HIV Infection in Resource-Limited Settings
title_sort	ip-10 levels as an accurate screening tool to detect acute hiv infection in resource-limited settings
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/defa7c564ed94a25b38b022de8d8f3a1
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IP-10 Levels as an Accurate Screening Tool to Detect Acute HIV Infection in Resource-Limited Settings

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