IP-10 Levels as an Accurate Screening Tool to Detect Acute HIV Infection in Resource-Limited Settings
Pastor Palomo, Lucía (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Casellas, Aina (Hospital Clínic i Provincial de Barcelona)
Carrillo, Jorge (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Alonso, Sergi (Hospital Clínic i Provincial de Barcelona)
Parker, Erica (School of Paediatrics and Child Health, University of Western Australia)
Fuente-Soro, Laura (Hospital Clínic i Provincial de Barcelona)
Jairoce, Chenjerai (Centro de Investigação em Saúde da Manhiça (CISM))
Mandomando, Inacio (Centro de Investigação em Saúde da Manhiça (CISM))
Blanco, Julià (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Naniche, Denise (Hospital Clínic i Provincial de Barcelona)

Data:	2017
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Scientific reports, Vol. 7 (august 2017) , ISSN 2045-2322

DOI: 10.1038/s41598-017-08218-0
PMID: 28808319

9 p, 2.8 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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