Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 212, Issue 5, Pages 754-759Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiv110
Keywords
HIV; preexposure prophylaxis; antibody maturation; incidence assay
Categories
Funding
- NIAID, National Institutes of Health (NIH) [AI51794]
- National Research Foundation [67385]
- Columbia University-Southern African Fogarty AIDS International Training and Research Programme - Fogarty International Center, NIH [D43TW00231]
- LifeLab, a biotechnology centre of the South African Government Department of Science and Technology
- US Agency for International Development (USAID)
- FHI360 (USAID) [GPO-A-00-05-00022-00, 132119]
- Technology Innovation Agency (LifeLab)
- CONRAD, Eastern Virginia Medical School (USAID) [GP00-08-00005-00, PPA-09-046]
- HIV Prevention Trials Network
- NIAID
- National Institute on Drug Abuse
- National Institute of Mental Health
- Office of AIDS Research, NIH [UM1AI068613]
- NIAID [R01 AI095068]
- Division of Intramural Research, NIAID, NIH
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The CAPRISA 004 preexposure prophylaxis (PrEP) randomized trial demonstrated that women who used a vaginal gel containing the antiretroviral drug tenofovir (TFV) had a 39% lower risk of acquiring human immunodeficiency virus (HIV). It is not known whether topical TFV alters the antibody response to breakthrough HIV infection. In this study, antibody maturation was evaluated using 3 serologic assays: the BED capture enzyme immunoassay (CEIA), the Bio-Plex (Luminex) assay, and the Bio-Rad avidity assay. Tests were performed using serum samples collected 3, 6, 9, 12, 24, 36, 48, and >48 months after seroconversion from 95 women in the CAPRISA 004 trial (35 in the TFV gel arm and 60 in the placebo arm). For the BED CEIA and Luminex assay, linear mixed effects models were used to examine test results by study arm. Cox proportional hazard analysis was used to examine time to avidity cutoff. Anti-HIV antibody titers did not differ between study arms. Women assigned to TFV gel demonstrated slower antibody avidity maturation, as determined by the Bio-Rad (P = .04) and gp120 Bio-Plex (P = .028) assays. Women who were assigned to receive topical TFV but became infected had slower antibody avidity maturation, with potential implications for diagnosis and antibody-based incidence assays as access to antiretroviral therapy-based PrEP is increased.
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