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Viral RNA and p24 antigen as markers of HIV disease and antiretroviral treatment success


Schüpbach, J (2003). Viral RNA and p24 antigen as markers of HIV disease and antiretroviral treatment success. International Archives of Allergy and Immunology, 132(3):196-209.

Abstract

HIV-1 RNA has become the standard for monitoring antiretroviral therapies. Dogma predicts, however, that a viral protein like p24 should be at least as good a marker of HIV disease activity, provided that it is measured with sufficient sensitivity and accuracy. Simple modifications including use of a more efficient virus lysis buffer, heat-mediated destruction of antibodies interfering with antigen detection, and tyramide signal amplification for increased sensitivity have highly improved the HIV-1 p24 antigen assay. The p24 antigen assay is inferior to RT-PCR in detecting viral particles, but the presence of extraviral p24 antigen in most samples makes largely up for this. p24 antigen testing is similarly sensitive and specific in diagnosing pediatric HIV infection, in predicting CD4+ T cell decline and clinical progression at early and late stage of infection, and suitable for antiretroviral treatment monitoring in both adults and children. Notably, p24 antigen was measurable even in patients with stably suppressed viremia, and its concentrations were correlated negatively with the concentrations of CD4+ T cells and positively with the concentrations of activated CD8+ T cell subsets. p24 antigen is an excellent marker of HIV expression and disease activity and can be used in the same fields of application as HIV RNA is used. The test is validated for subtype B, but requires further studies for non-B subtypes.

HIV-1 RNA has become the standard for monitoring antiretroviral therapies. Dogma predicts, however, that a viral protein like p24 should be at least as good a marker of HIV disease activity, provided that it is measured with sufficient sensitivity and accuracy. Simple modifications including use of a more efficient virus lysis buffer, heat-mediated destruction of antibodies interfering with antigen detection, and tyramide signal amplification for increased sensitivity have highly improved the HIV-1 p24 antigen assay. The p24 antigen assay is inferior to RT-PCR in detecting viral particles, but the presence of extraviral p24 antigen in most samples makes largely up for this. p24 antigen testing is similarly sensitive and specific in diagnosing pediatric HIV infection, in predicting CD4+ T cell decline and clinical progression at early and late stage of infection, and suitable for antiretroviral treatment monitoring in both adults and children. Notably, p24 antigen was measurable even in patients with stably suppressed viremia, and its concentrations were correlated negatively with the concentrations of CD4+ T cells and positively with the concentrations of activated CD8+ T cell subsets. p24 antigen is an excellent marker of HIV expression and disease activity and can be used in the same fields of application as HIV RNA is used. The test is validated for subtype B, but requires further studies for non-B subtypes.

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25 citations in Web of Science®
30 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Institute of Medical Virology
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:1 November 2003
Deposited On:11 Feb 2008 12:28
Last Modified:07 Jul 2016 13:31
Publisher:Karger
ISSN:1018-2438
Publisher DOI:10.1159/000074552
PubMed ID:14646380
Permanent URL: http://doi.org/10.5167/uzh-2183

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