Quantification of human immunodeficiency virus type 1 p24 antigen and antibody rivals human immunodeficiency virus type 1 RNA and CD4+ enumeration for prognosis

Jennifer S. Read, Kenneth C. Rich, James J. Korelitz, Lynne M. Mofenson, D. Robert Harris, John H. Moye, William A. Meyer, Savita G Pahwa, James W. Bethel, Robert P. Nugent

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background. The sensitivity, specificity and positive predictive value of baseline serum concentrations of HIV-1 immune complex-dissociated (ICD) p24 antigen for predicting disease progression and mortality were assessed and compared with results obtained for HIV-1 ICD p24 antigen with HIV-1 p24 antibody and for HIV-1 RNA with CD4+ lymphocyte percent. Methods. Data from HIV-infected children enrolled in a North American clinical trial (National Institute of Child Health and Human Development Intravenous Immunoglobulin Clinical Trial) were analyzed. Disease progression was defined as growth failure, CD4+ lymphocyte percent decline to <15% after study entry or development of an AIDS-defining opportunistic infection. Results. Baseline samples were available for ICD p24 antigen testing (median concentration, 319 pg/ml; range, <50 to 15 640) in 240 children. The combination of detectable ICD p24 antigen and low p24 antibody was more sensitive but less specific than the combination of high HIV-1 RNA and low CD4+ lymphocyte percent in predicting disease progression and mortality. Using receiver operating characteristic curves, the specificity of ICD p24 antigen with p24 antibody for classifying children's disease progression or mortality was as great as, or greater than, HIV-1 RNA with CD4+ lymphocyte percent at points on the curve corresponding to higher sensitivity. Conclusions. The use of ICD p24 antigen with p24 antibody to identify children at high risk of disease progression or mortality could be a viable alternative to the more expensive and technically difficult HIV-1 RNA and CD4+ lymphocyte assays in resource- poor settings, including developing countries where the majority of children with HIV-1 infection reside.

Original languageEnglish
Pages (from-to)544-551
Number of pages8
JournalPediatric Infectious Disease Journal
Volume19
Issue number6
DOIs
StatePublished - Jun 1 2000
Externally publishedYes

Fingerprint

HIV-1
Antigen-Antibody Complex
RNA
Antigens
Antibodies
Disease Progression
Lymphocytes
Mortality
HIV Core Protein p24
National Institute of Child Health and Human Development (U.S.)
Clinical Trials
Intravenous Immunoglobulins
Opportunistic Infections
ROC Curve
Developing Countries
HIV Infections
Acquired Immunodeficiency Syndrome
HIV
Sensitivity and Specificity
Growth

Keywords

  • Human immunodeficiency virus
  • Pediatrics
  • Progression
  • Proteins

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)

Cite this

Quantification of human immunodeficiency virus type 1 p24 antigen and antibody rivals human immunodeficiency virus type 1 RNA and CD4+ enumeration for prognosis. / Read, Jennifer S.; Rich, Kenneth C.; Korelitz, James J.; Mofenson, Lynne M.; Harris, D. Robert; Moye, John H.; Meyer, William A.; Pahwa, Savita G; Bethel, James W.; Nugent, Robert P.

In: Pediatric Infectious Disease Journal, Vol. 19, No. 6, 01.06.2000, p. 544-551.

Research output: Contribution to journalArticle

Read, Jennifer S. ; Rich, Kenneth C. ; Korelitz, James J. ; Mofenson, Lynne M. ; Harris, D. Robert ; Moye, John H. ; Meyer, William A. ; Pahwa, Savita G ; Bethel, James W. ; Nugent, Robert P. / Quantification of human immunodeficiency virus type 1 p24 antigen and antibody rivals human immunodeficiency virus type 1 RNA and CD4+ enumeration for prognosis. In: Pediatric Infectious Disease Journal. 2000 ; Vol. 19, No. 6. pp. 544-551.
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abstract = "Background. The sensitivity, specificity and positive predictive value of baseline serum concentrations of HIV-1 immune complex-dissociated (ICD) p24 antigen for predicting disease progression and mortality were assessed and compared with results obtained for HIV-1 ICD p24 antigen with HIV-1 p24 antibody and for HIV-1 RNA with CD4+ lymphocyte percent. Methods. Data from HIV-infected children enrolled in a North American clinical trial (National Institute of Child Health and Human Development Intravenous Immunoglobulin Clinical Trial) were analyzed. Disease progression was defined as growth failure, CD4+ lymphocyte percent decline to <15{\%} after study entry or development of an AIDS-defining opportunistic infection. Results. Baseline samples were available for ICD p24 antigen testing (median concentration, 319 pg/ml; range, <50 to 15 640) in 240 children. The combination of detectable ICD p24 antigen and low p24 antibody was more sensitive but less specific than the combination of high HIV-1 RNA and low CD4+ lymphocyte percent in predicting disease progression and mortality. Using receiver operating characteristic curves, the specificity of ICD p24 antigen with p24 antibody for classifying children's disease progression or mortality was as great as, or greater than, HIV-1 RNA with CD4+ lymphocyte percent at points on the curve corresponding to higher sensitivity. Conclusions. The use of ICD p24 antigen with p24 antibody to identify children at high risk of disease progression or mortality could be a viable alternative to the more expensive and technically difficult HIV-1 RNA and CD4+ lymphocyte assays in resource- poor settings, including developing countries where the majority of children with HIV-1 infection reside.",
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T1 - Quantification of human immunodeficiency virus type 1 p24 antigen and antibody rivals human immunodeficiency virus type 1 RNA and CD4+ enumeration for prognosis

AU - Read, Jennifer S.

AU - Rich, Kenneth C.

AU - Korelitz, James J.

AU - Mofenson, Lynne M.

AU - Harris, D. Robert

AU - Moye, John H.

AU - Meyer, William A.

AU - Pahwa, Savita G

AU - Bethel, James W.

AU - Nugent, Robert P.

PY - 2000/6/1

Y1 - 2000/6/1

N2 - Background. The sensitivity, specificity and positive predictive value of baseline serum concentrations of HIV-1 immune complex-dissociated (ICD) p24 antigen for predicting disease progression and mortality were assessed and compared with results obtained for HIV-1 ICD p24 antigen with HIV-1 p24 antibody and for HIV-1 RNA with CD4+ lymphocyte percent. Methods. Data from HIV-infected children enrolled in a North American clinical trial (National Institute of Child Health and Human Development Intravenous Immunoglobulin Clinical Trial) were analyzed. Disease progression was defined as growth failure, CD4+ lymphocyte percent decline to <15% after study entry or development of an AIDS-defining opportunistic infection. Results. Baseline samples were available for ICD p24 antigen testing (median concentration, 319 pg/ml; range, <50 to 15 640) in 240 children. The combination of detectable ICD p24 antigen and low p24 antibody was more sensitive but less specific than the combination of high HIV-1 RNA and low CD4+ lymphocyte percent in predicting disease progression and mortality. Using receiver operating characteristic curves, the specificity of ICD p24 antigen with p24 antibody for classifying children's disease progression or mortality was as great as, or greater than, HIV-1 RNA with CD4+ lymphocyte percent at points on the curve corresponding to higher sensitivity. Conclusions. The use of ICD p24 antigen with p24 antibody to identify children at high risk of disease progression or mortality could be a viable alternative to the more expensive and technically difficult HIV-1 RNA and CD4+ lymphocyte assays in resource- poor settings, including developing countries where the majority of children with HIV-1 infection reside.

AB - Background. The sensitivity, specificity and positive predictive value of baseline serum concentrations of HIV-1 immune complex-dissociated (ICD) p24 antigen for predicting disease progression and mortality were assessed and compared with results obtained for HIV-1 ICD p24 antigen with HIV-1 p24 antibody and for HIV-1 RNA with CD4+ lymphocyte percent. Methods. Data from HIV-infected children enrolled in a North American clinical trial (National Institute of Child Health and Human Development Intravenous Immunoglobulin Clinical Trial) were analyzed. Disease progression was defined as growth failure, CD4+ lymphocyte percent decline to <15% after study entry or development of an AIDS-defining opportunistic infection. Results. Baseline samples were available for ICD p24 antigen testing (median concentration, 319 pg/ml; range, <50 to 15 640) in 240 children. The combination of detectable ICD p24 antigen and low p24 antibody was more sensitive but less specific than the combination of high HIV-1 RNA and low CD4+ lymphocyte percent in predicting disease progression and mortality. Using receiver operating characteristic curves, the specificity of ICD p24 antigen with p24 antibody for classifying children's disease progression or mortality was as great as, or greater than, HIV-1 RNA with CD4+ lymphocyte percent at points on the curve corresponding to higher sensitivity. Conclusions. The use of ICD p24 antigen with p24 antibody to identify children at high risk of disease progression or mortality could be a viable alternative to the more expensive and technically difficult HIV-1 RNA and CD4+ lymphocyte assays in resource- poor settings, including developing countries where the majority of children with HIV-1 infection reside.

KW - Human immunodeficiency virus

KW - Pediatrics

KW - Progression

KW - Proteins

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