Pan-HIV Incidence Assay Development

PanHIV Incidence Assay DevelopmentAbstractHIVcontinues to cause the largest number of yearly deaths from a single infectious agent in the world todayDespiteconsiderableadvancesintreatmentofHIVinfectionandAIDSwhichitcausesthereisanurgentneed for better methods of prevention and treatment of HIVinfection and AIDSAs part of this effortthe WorldHealth OrganizationWHOand the Joint United Nations Program on HIV AIDSUNAIDSconduct worldwidesurveys of HIV infection incidenceprevalence and mortalityIncidence data are vitally needed by governmentsandnongovernmentalorganizationstobestdirecteffortsandlimitedresourcesaimedatpreventionofHIVtransmission and treatment of HIV infectionThe limiting antigen avidity enzyme immunoassayLag assayiscurrently widely used to test for HIV incidence but this assay only detects very recent infections and does notwork well for all subtypes of HIVAntigen Discovery IncADIof Irvine Californiahas created a panHIV proteomic microarraypanHIV chipthatcontainsallproteinsandmanyproteinfragmentsandepitopesfromnineHIVsubtypesandcirculatingrecombinant forms as well as both major groups of HIVwhich together comprise overof HIV infectionsworldwideWealsoaddedglycosylatedanddisulfideboundformsofHIVglycoproteinsandglycoproteinfragmentsresultinginatotalofoverimmunoreactiveHIVproteinsproteinsfragmentsandepitopesMoreoverwe assayed the reactivity of this HIV protein microarray with IgGIgA and IgM in a panel ofseraand saliva samplesobtained from the Consortium for the Evaluation and Performance of HIV Incidence AssaysCEPHIAthatcomprisetheHIVRecencyBiomarkerScreeningHRBSsetOurpreliminarydatashowthatcertain HIV antigensVifVpupTatRevEnv and Env fragments are much less strongly recognized by IgGin sera and saliva from recently infected individuals compared to those with longerterm infectionIn contrastEnvEnv fragmentsTatRevCA and PR are more strongly recognized by IgM in sera and saliva from recentlyinfected individuals compared to those with longerterm infectionBased on these extensive preliminary datawehypothesizethatwecandevelopahighlysensitiveandspecificHIVrecencyofinfectiontestingalgorithmRITAthat will be useful for individuals infected with all types and subtypes of HIVPanHIV Incidence Assay DevelopmentAbstractHIVcontinues to cause the largest number of yearly deaths from a single infectious agent in the world todayDataonhowmanynewinfectionsoccuryearlyarevitallyneededtobestdirecteffortsandlimitedresourcesaimed at prevention of HIV transmission and treatment of HIV infectionThe current test for new HIV infectionsis not optimalwe plan to develop a more comprehensive and specific test of recent HIV infection