AEGiS-13IAC: Increased detection of HIV-2 in specimens submitted for HIV-1 testing in New York City from 1988 to the present.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Increased detection of HIV-2 in specimens submitted for HIV-1 testing in New York City from 1988 to the present.

Int Conf AIDS 2000 Jul 9-14; 13:33 (abstract no.. LbPeA7009)

Beatrice S, Oleszko W, Punsalang A, El-Fishawy M
New York City Department of Health, NY 10016. Fax: 212-447-2877, E-mail: stbeatrice@compuserve.com.

BACKGROUND: As a result of large numbers of immigrants moving to New York City from HIV-2 endemic areas, since 1988, the NYC Dept of Health (DOH) has been performing HIV-2 antibody (Ab) screening on samples testing inconclusive for HIV- I Ab. However, persons infected with HIV-2 would be missed if they either lacked cross-reacting HIV-1 Ab or had sufficient HIV-1 cross-reacting Ab to be considered positive for HIV-1 infection. In order to better identify HIV-2 infected patients, a more efficient HIV-2 testing algorithm was needed.

METHODS: Between 1/88 and 1/98, the NYC DOH screened all submitted samples in replicate using an FDA approved HIV-1 EIA and a confirmatory HIV-1 Western blot (algorithm 1). In 2/98, a combination HIV-1/HIV-2 EIA assay replaced the standard HIV-1 EIA (algorithm 2). In 7/98, all HIV-1 positive samples were tested using the Sanofi HIV-1/HIV-2 Multispot Rapid Assay (algorithm 3). Patient birth origin was recorded.

RESULTS: Between 7/88 and 2/00, 159 HIV-2 positive specimens were detected: 29 between 7/88 and 7/98 through prospective screening of HIV-1 inconclusives (algorithms 1/2), 50 between 1/93 and 7/98 through retrospective screening of African-born patients (algorithms 1/2), and 80 between 7/98 and 2/00 through prospective screening of HIV-1 inconclusives and HIV-1 positives (algorithm 3). 108 tested HIV-1 positive, 41 were inconclusive for HIV-1, and 10 were HIV-1 negative. Patient birth origin was as follows: Africa (120), Asia (2), Caribbean (5), North America (19), Europe (1), and unknown (12).

CONCLUSIONS: We observed an increased number of HIV-2 positives detected based on an expanded testing algorithm. Most HIV-2 infections were hidden in HIV-1 cross-reacting Ab. HIV-2 positives were observed from all regions of the world. HIV-2 infections need to be correctly identified because of HIV-1 viral load assay inability to amplify HIV-2 and because various anti-retrovirals, particularly NNRTIs, may be ineffective against HIV-2.

Keywords: AEGIS, HIV-2, HIV-1, HIV Antibodies, HIV Infections, Mass Screening, Blotting, Western, HIV Seropositivity, HIV-1 Reverse Transcriptase, Algorithms, Retrospective Studies, New York City, Africa, Asia, Europe, North America, Caribbean Region, Human, immunology, AIDS
000709
LbPeA7009