Shortening Window period in HIV detection

[Guest guest]

Dear Forum,

Researchers in Israel and Kenya have shown that the contribution of variable

degrees of immune suppression, either due to existing chronic infections such as

parasitemias and/or nutrition, in different populations may influence and

prolong the serological-diagnostic window period of HIV.

However, the immunosuppression can be overcome, by in-vitro enhancement of

antibody production (termed- Stimmunology). The results, which appear in the

August 2009 issue of Experimental Biology and Medicine, show that pre-treating

the whole blood sample in the SMARTubeâ„¢ containing immune potentiating agents

promoted the synthesis and release of antibodies against HIV-1 prior to their

detection in corresponding plasma samples in a group of donors who would

otherwise be classified as HIV-1 seronegative blood donors.

The identification of techniques that can lead to detection of HIV infection

during this window period is of obvious public health importance especially in

resource poor settings highlighting the importance of these findings.

The suppression, in-vitro, led to the production of detectable levels of

anti-HIV antibodies in the whole blood sample and to the detection of

potentially infectious blood units which were missed by regular HIV serology.

Interestingly, the ratio of missed infections among the total HIV infected blood

donors was higher among the younger (high-school) donors versus adult donors.

The research team, Dr. Jasper Mumo, immunologist from the Department of Human

Pathology, University of Nairobi, Kenya, Dr. Ami Vansover, head of the Virology

Laboratory, Public Health Laboratories, Ministry of Health, Israel, and Dr.

Tamar Jehuda-Cohen, an immunologist, Faculty of Biomedical Engineering,

Technion-Israel Institute of Technology, ran the same HIV antibody tests using

both regular plasma and SMART-plasma (plasma after the Stimmunology step) from

blood donors in Kenyata hospital.

Dr. Jehuda-Cohen noted that " this study, offers one of the keys to making the

blood supply safer, by overcoming the problem of this protracted window period

perhaps unique to certain field study sites with a high incidence/prevalence of

HIV-1. This is true not only for HIV but also for other infections such as HCV,

which has even a longer window period than HIV "

In summary, in-vitro enhancement of antibody production, made simple by the

SMARTubeâ„¢, has been shown to enable the earlier detection of HIV infection.

This is critical for saving lives not only via a safer blood supply but also by

detection of HIV infection among pregnant women who seem to have a very long

window period.

" A pregnant women testing false negative for HIV will not be offered ART which

could have saved her baby " said Dr. Jehuda-Cohen (a mother of seven).

Dr. R. Goodman, Editor-in-Chief of Experimental Biology and Medicine said

" The article by Mumo and colleagues may lead to a change in testing paradigms

and algorithms in HIV and other infections with a diagnostic window period. "

Dr Diwakar Tejaswi

MBBS(Gold Medalist); MCH; FCCP; Ph.D

Consultant Physician and Medical Director

Public Awareness for Healthful Approach for Living (PAHAL)

111, Harinarayan Complex, Exhibition Road, Patna 800001, India

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