3rd Conference on Retroviruses and Opportunistic Infections Washington, DC - January 28-February 1, 1996

Conf Retroviruses Opportunistic Infect 1996 Jan 28-Feb 1; 3rd:60 (abstract no. 38)

Busch MP¹, Herman SA², Henrard DR³, Satten GA⁴, Garrett PE⁴, Aubuchon JP⁶, Schreiber GB⁷, and REDS
¹ Irwin Meml Blood Ctrs, San Francisco CA; ² Roche Molecular Systems, Somerville NJ; ³ Pasteur Inst, Paris; ⁴ CDC, Atlanta GA; ⁵ Boston Biomedica, Bridgewater MA; ⁶ Dartmouth-Hitchcock Med Ctr, Lebanon NH; ⁷ Westat, Rockville MD.

INTRODUCTION: Kinetics of primary HIV viremia has implications for donor screening, clinical diagnosis, and understanding pathogenesis.

METHODS: 2 approaches were used to estimate window periods (WP) for HIV RNA (plasma RT-PCR), DNA (PBMC PCR), p24 Ag and lgM pre-lgG seroconversion (SC). A) viral marker data were obtained 3-6m pre-SC for 394 SCS from 6 cohort studies (348 gay men; 46 IDUs); results were analyzed using a maximum-likelihood WP model. B) 250 serial (2-10d interval) samples from 34 SC plasma donors were tested by quantitative RNA and p24 Ag assays, and lgM (Abbott) and lgG (GSC) sensitive anti-HIV tests. WPs were estimatedby Markov modeling; viral replication rates by linear regression.

RESULTS: Of the 394 cohort SCs, 13% were lgM + on the pre-lgG SC visit; the pre-lgM + visit was p24 Ag/DNA PCR + in 6%, RNA+ in 8%. WP estimates were: lgM (pre-lgG), 23.5d (16.7-30.2); p24Ag/DNA (pre-lgM), 10.5d (8.5-18); RNA (pre-lgM), 13.2d (8.5-18). Calculated viral doubling time pre-SC was 0.53-1.42d (mean 0.95d). Based on incidence rates in donors of 4/10⁵ person-yrs, the projected yields of p24 Ag and RNA screening units are 8 and 15/10⁷ units, at a projected cost of $2.3 and 2.0 million/QALY, respectively.

CONCLUSIONS: These data allow projection of the yield of direct virus detection assay yield, and suggest that the rate of HIV production established during primary dissemination is similar to that of chronic infections.

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Copyright © 1996 - Foundation for Retrovirology and Human Health . Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health.