DOCSLIB.ORG

HIV Seroconversion Illness Update Latest HIV Assays May Still Be Negative

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
HIV Seroconversion Illness Update Latest HIV Assays May Still Be Negative CLINICAL PRACTICE HIV seroconversion illness Update Latest HIV assays may still be negative Human immunodeficiency virus (HIV) seroconversion illness occurs in up to 80% of patients who newly acquire the virus. It is hoped that the new fourth generation HIV assay will have improved sensitivity for diagnosis. This article describes Matthew Shields the case of a patient who presented with typical symptoms of HIV seroconversion illness but who had a negative initial MBBS, FRACGP, DipGUM(Lond), test with the new assay. Current management of HIV seroconversion illness is also outlined. DFFP, is a registrar in sexual health and HIV medicine, Darlinghurst, New South Wales. mdshields@hotmail. com Case study Mr D, a homosexual man aged 34 years, presented with a 3 day history of painful ulcers in the mouth and on the penis associated with high fever and night sweats, malaise, myalgia, headache, and a sore throat. He had unprotected anal intercourse with a HIV positive casual partner 10 days previously. Four days after this casual contact he presented to his general practitioner with a profuse urethral discharge which was diagnosed as urethral gonorrhoea. This responded well to intramuscular ceftriaxone. Mr D was previously very well with no medical problems or allergies and reported a negative HIV test 3 months earlier. On examination he appeared very unwell with a temperature of 380C and mild dehydration. There was no rash. Examination of the mouth revealed tender ulceration of the hard palate (Figure 1) and a diffuse erythematous pharyngitis. Genital examination revealed one large, slightly tender ulcer (1.5 cm) on the shaft of the penis. Inguinal nodes were not enlarged or tender and there was no other lymphadenopathy. The ulcer was deep and without induration. Syphilis and HIV serology were performed and a swab from the penile ulcer was sent for herpes simplex virus (HSV) polymerase chain reaction (PCR). HIV screening utilised a fourth generation assay for combined HIV antibody and p24 antigen detection. The result, available later that day, was negative. The patient was seen 2 days later for clinical review, The patient was counselled appropriately and repeat HIV serology, and full sexually transmitted initiated on a short course of antiretroviral (ARV) infection (STI) screening. He showed improvement therapy that day with lopinavir/ritonavir, tenofovir and systemically but had additional oral discomfort. 3TC.1 Herpes simplex virus PCR from the penile ulcer Examination revealed some additional ulceration was negative. Syphilis serology at presentation and at of the oral labial mucosa as well as the hard palate, weeks 4 and 12 were also negative, excluding syphilis but the penile ulceration was much improved. and indicating genital ulceration was occurring in the Posterior cervical nodes were now palpable bilaterally context of HIV seroconversion. Repeat HIV serology and Mr D had developed a faint pink truncal macular in subsequent weeks revealed evolving reactivity on rash (Figure 2). the western blot, and a viral load taken with symptoms was more than 750 000; both results consistent The repeat fourth generation assay that day was reactive. with seroconversion. Additional tests, including western blot, revealed one Basic blood tests including full blood count (FBC), reactive band (p24) and the isolated p24 antigen assay electrolytes, urea, creatinine (EUC), and liver function (a more specific test) was reactive, confirming HIV tests (LFTs) taken at the initial visit revealed a transient seroconversion illness. thrombocytopaenia and lymphopaenia, and mild hepatitis, Reprinted from Australian Family Physician Vol. 35, No. 7, July 2006 523 CLINICAL PRACTICE HIV seroconversion illness – latest HIV assays may still be negative Other tests are sometimes used for diagnosing seroconversion (eg . PCR). However, HIV RNA PCR (viral load) assays are quantitative tests and cannot be relied upon for diagnosis because of poor specificity in the form of low level false positives.3 Proviral DNA is a HIV DNA PCR test that is more sensitive and more specific than a viral load assay making it a good second line test or Figure 1. Ulceration of the hard palate useful adjunct to the fourth generation assay. Photo courtesy Mark Nelson, The Chelsea and Westminster Hospital, London A proviral DNA requires a whole blood sample. It is important to indicate on the request with LFTs no more that twice the upper limit of form, or telephone the reference laboratory, if normal. Hepatitis B status previously recorded in seroconversion illness is suspected. the notes indicated the patient was a hepatitis B Management of seroconversion illness exposed noncarrier (natural immunity). Pa t i e n t s c o n f i r m e d o r s u s p e c t e d o f Discussion HIV seroconversion illness should be Human immunodeficiency virus seroconversion referred immediately to a HIV specialist Figure 2. Patient displaying truncal macular rash illness (or primary HIV infection) is thought Photo courtesy Mark Nelson, The Chelsea and general practitioner or sexual health to occur in up to 80% of patients who newly Westminster Hospital, London service (Table 1). acquire the virus.2,3 It typically occurs 10–14 days Prompt treatment of confirmed HIV after infection. Symptoms last approximately 1 serology was requested. Syphilis serology seroconversion with a short course of ARV week. Classic symptoms include: is essential in all men who have sex therapy (usually 3–6 months) is an option. This • fever with men presenting with the above syndrome. is not standard of care but is at the discretion • rash of the treating physician and patient. Treating Testing for seroconversion illness • malaise seroconversion illness with a short course of • sore throat, and Experience with third generation (antibody ARV drugs has the potential to slow disease • generalised lymphadenopathy.4,5 only) HIV enzyme immunoassays (EIA) in progression by preserving HIV specific Because these symptoms are transient and recent years suggests these tests become cytotoxic T-lymphocyte responses.9 However, influenza-like, seroconversion illness often goes positive around the time of seroconversion the evidence base is small and it remains an unrecognised by both the patient and doctor. illness. This makes sense because as the name important unanswered study question.10 Other known manifestations are oral and genital suggests, seroconversion illness is the time Further data is expected from SPARTAC, a large ulceration. Potential neurological complications of seroconversion to HIV antibody. Therefore international multicentre trial rolled out last include meningitis, encephalitis, and Guillain these EIAs may be negative on a sample year by St Mary’s Hospital, London, currently Barre syndrome.6 The transient drop in CD4 taken 1 day during the illness but positive on a randomising seroconverters to treatment or not. count that may occur during seroconversion sample taken the following day. Other potential advantages of treating may also push the patient into the realm of well The fourth generation assay (that combines seroconversion include reduction of symptoms known HIV related disease (eg. oral candidiasis p24 antigen) should prove a more sensitive test and reduced risk of HIV transmission. or pneumocystis carinii pneumonia). for HIV seroconversion because p24 antigen Potential disadvantages include toxicity, The differential diagnosis of a febrile illness typically appears 5 days before antibody.7,8 This financial cost, and the potential to foster or with generalised rash and lymphadenopthy test is the same test now used for general potentiate a drug resistant virus. Studies could include: HIV screening by all reference laboratories in indicate that treatment with ARV drugs • HIV seroconversion Australia. requires more than 95% compliance to guard • secondary syphilis Overall the fourth generation combined against developing drug resistance.11 Such • Epstein Barr virus (EBV) antibody/antigen assay is the best first line test compliance could be undermined by the • cytomegalovirus (CMV) for the diagnosis of suspected seroconversion. trauma of the new HIV diagnosis, thereby • acute toxoplasmosis However, as this case suggests, this assay may fostering drug resistant virus. In addition, the • acute hepatitis B, and still be negative with peak symptoms. A repeat transmission of drug resistant virus is a real • rubella.6 sample and test in 2–3 days is recommended entity and such virus can be potentiated by In this patient, however, only HIV and syphilis when there is an index of suspicion. an immediate course of ARV therapy.9 In this 524 Reprinted from Australian Family Physician Vol. 35, No. 7, July 2006 HIV seroconversion illness – latest HIV assays may still be negative CLINICAL PRACTICE but still may initially be negative, necessitating a Table 1. Management algorithm for HIV repeat sample in 2–3 days. Patients confirmed or seroconversion illness suspected of HIV seroconversion illness should Could this be seroconversion illness? be referred immediately to a HIV specialist GP or • Was there a substantial risk sexual health service. (eg. unprotected anal intercourse)? • What is the time course (10–14 Acknowledgment days)? Thanks to Dr Robert Finlayson, TSPC, and Phillip • Are typical symptoms present Cunningham, St Vincent's HIV Lab, Sydney, New (eg. fever, rash, sore throat, malaise, generalised lymphadenopathy)? South Wales. HIV test Conflict of interest: none declared. • Provide patient with pretest counselling References • Indicate suspected seroconversion 1. Fidler S. Comparative potency of three antiretrovi- ral therapy regimens in primary HIV infection. AIDS on the request form, or telephone 2006;20:247–52. the reference laboratory 2. Schacker T, Collier A, Hughes J, et al. Clinical and • Fourth generation assay (ask if same epidemiological features of primary HIV infection. Ann day result is available) Intern Med 1996;125:257–64. • Consider proviral DNA if available 3. Hecht F, Busch M, Rawal B, et al. Use of laboratory tests (requires a whole blood sample) and clinical symptoms to identify primary HIV infection. AIDS 2002;16:1119–29. • Undertake full STI screening 4. Cooper D, Gold J, Maclean P, et al.
Load more

Recommended publications
  • Human B Cell Clonal Expansion and Convergent Antibody Responses to SARS-Cov-2
    bioRxiv preprint doi: https://doi.org/10.1101/2020.07.08.194456; this version posted July 9, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY-NC-ND 4.0 International license. 1 Human B cell clonal expansion and convergent antibody responses to SARS- 2 CoV-2 3 Authors: Sandra C. A. Nielsen1,12, Fan Yang1,12, Katherine J. L. Jackson2,12, Ramona A. Hoh1,12, 4 Katharina Röltgen1, Bryan Stevens1, Ji-Yeun Lee1, Arjun Rustagi3, Angela J. Rogers4, Abigail E. 5 Powell5, Javaria Najeeb6, Ana R. Otrelo-Cardoso6, Kathryn E. Yost7, Bence Daniel1, Howard Y. 6 Chang7,8, Ansuman T. Satpathy1, Theodore S. Jardetzky6,9, Peter S. Kim5,10, Taia T. Wang3,10,11, 7 Benjamin A. Pinsky1, Catherine A. Blish3,10*, Scott D. Boyd1,9,13* 8 Affiliations: 9 1Department of Pathology, Stanford University, Stanford, CA 94305, USA. 10 2Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia. 11 3Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford 12 University, Stanford, CA 94305, USA. 13 4Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Stanford 14 University, Stanford, CA 94305, USA. 15 5Stanford ChEM-H and Department of Biochemistry, Stanford University, Stanford, CA 94305, 16 USA. 17 6Department of Structural Biology, Stanford University, Stanford, CA 94305, USA. 18 7Center for Personal Dynamic Regulomes, Stanford University, Stanford, CA 94305, USA. 19 8Howard Hughes Medical Institute, Stanford University, Stanford, CA 94305, USA.
    [Show full text]
  • Seroconversion Stages COVID19 Into Distinct Pathophysiological States
    medRxiv preprint doi: https://doi.org/10.1101/2020.12.05.20244442; this version posted December 7, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license . Seroconversion stages COVID19 into distinct pathophysiological states Matthew D. Galbraith1,2, Kohl T. Kinning1, Kelly D. Sullivan1,3, Ryan Baxter4, Paula Araya1, Kimberly R. Jordan4, Seth Russell5, Keith P. Smith1, Ross E. Granrath1, Jessica Shaw1, Monika DzieCiatkowska6, Tusharkanti Ghosh7, Andrew A. Monte8, Angelo D’Alessandro6, Kirk C. Hansen6, Tellen D. Bennett9, Elena W.Y. Hsieh4,10 and Joaquin M. Espinosa1,2* Affiliations: 1Linda CrniC Institute for Down Syndrome; 2Department of PharmaCology; 3Department of PediatriCs, Division of Developmental Biology; 4Department of Immunology and MiCrobiology; 5Data Science to Patient Value; 6Department of BioChemistry and MoleCular GenetiCs; 7Department of BiostatistiCs and InformatiCs, Colorado SChool of PubliC Health; 8Department of EmergenCy MediCine; 9Department of PediatriCs, SeCtions of Informatics and Data Science and Critical Care Medicine; 10Department of PediatriCs, Division of Allergy/Immunology; University of Colorado AnsChutz MediCal Campus, Aurora, CO, USA. *CorrespondenCe to: [email protected] ABSTRACT COVID19 is a heterogeneous mediCal Condition involving a suite of underlying pathophysiologiCal processes including hyperinflammation, endothelial damage, thrombotiC miCroangiopathy, and end- organ damage. Limited knowledge about the moleCular meChanisms driving these proCesses and laCk of staging biomarkers hamper the ability to stratify patients for targeted therapeutiCs. We report here the results of a cross-sectional multi-omics analysis of hospitalized COVID19 patients revealing that seroconversion status associates with distinct underlying pathophysiological states.
    [Show full text]
  • Longitudinal Monitoring of SARS-Cov-2 Igm and Igg Seropositivity to Detect COVID-19
    Longitudinal Monitoring of SARS-CoV-2 IgM and IgG Seropositivity to Detect COVID-19 Raymond T. Suhandynata, Melissa A. Hoffman, Michael J. Kelner, Ronald W. McLawhon, Downloaded from https://academic.oup.com/jalm/article-abstract/doi/10.1093/jalm/jfaa079/5840731 by guest on 17 July 2020 Sharon L. Reed, and Robert L. Fitzgerald Department of Pathology UC San Diego Health Address correspondence to: [email protected] VC American Association for Clinical Chemistry 2020. All rights reserved. For permissions, please email: [email protected]. Summary: The clinical performance of the Diazyme SARS-CoV-2 assay was evaluated and deemed appropriate for patient testing using a cohort of 54 PCR positive patients and an additional 235 negative samples. The kinetics of IgM and IgG seroconversion in 14 PCR confirmed SARS-CoV-2 patients were characterized by Downloaded from https://academic.oup.com/jalm/article-abstract/doi/10.1093/jalm/jfaa079/5840731 by guest on 17 July 2020 SARS-CoV-2 IgM/IgG serology. Serology testing should be considered a complimentary test to support PCR testing to aid in the detection of asymptomatic cases and is useful for documenting previous exposures to SARS-CoV-2. 2 Abstract Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a novel beta-coronavirus that has recently emerged as the cause of the 2019 coronavirus pandemic (COVID-19). Polymerase chain reaction (PCR) based tests are optimal and recommended for the diagnosis of an acute SARS-CoV-2 Downloaded from https://academic.oup.com/jalm/article-abstract/doi/10.1093/jalm/jfaa079/5840731 by guest on 17 July 2020 infection.
    [Show full text]
  • Patterns of Negative Seroconversion in Ongoing Surveys of SARS-Cov-2 Antibodies Among Workers in New York's Largest Healthcare
    Workplace Occup Environ Med: first published as 10.1136/oemed-2021-107382 on 25 August 2021. Downloaded from Original research Patterns of negative seroconversion in ongoing surveys of SARS- CoV-2 antibodies among workers in New York’s largest healthcare system Grace Sembajwe ,1 Rehana Rasul,2 Yehuda Jacobs,3 Keisha Edwards,3 Lorraine Chambers Lewis,3 Tylis Chang,3 William Lowe,3 Jacqueline Moline4 ► Additional supplemental ABSTRACT Key messages material is published online Objectives Given the importance of continued only. To view, please visit the COVID-19 surveillance, our objective was to present journal online (http:// dx. doi. What is already known about this subject? org/ 10. 1136/ oemed- 2021- findings from a short follow- up survey of workforce ► Antibodies for COVID-19 decline over time. 107382). SARS- CoV-2 antibody testing in previously seropositive However, population patterns of negative participants and describe associations between work 1 seroconversion are not well understood. Occupational Medicine, locations and negative seroconversion. Epidemiology, and Prevention, Northwell Health Feinstein Methods We conducted a follow-up cross-sectional What are the new findings? Institutes for Medical Research, survey on previously seropositive healthcare workers, ► The study discovered sociodemographic and Great Neck, New York, USA using questionnaires and serology testing. Eligible 2 workplace patterns of negative seroconversion Biostatistics and Occupational employees previously consented to be contacted were Medicine, Epidemiology, and among healthcare workers. In a follow- up Prevention, Northwell Health, invited by email to participate in a survey and laboratory survey of 955 previously seropositive New Great Neck, New York, USA blood draws. SAS V.9.4 was used to describe employee 3 York healthcare workers, 176 retested negative Employee Health Services and characteristics and seroconversion status.
    [Show full text]
  • HIV Seroconversion Illness
    HIV Seroconversion Illness HIV seroconversion is the name given to a group of symptoms that can occur when someone first gets the virus. During this time, there are very high levels of HIV in the body. This is known as a high viral load. When a person has a high viral load, they can easily pass HIV to others. Standard HIV antibody tests do not detect the virus in new infections, so a person may unknowingly pass HIV at this time. Causes When a person gets HIV, the virus makes copies in white blood cells, called CD4 lymphocytes. The immune system responds with HIV antigens and the body begins to make antibodies to HIV. This immune response causes the symptoms of the seroconversion illness. Symptoms The symptoms that occur during HIV seroconversion are common to many kinds of illnesses, including the flu. During the early stage of new HIV infection, up to 90% of people will experience flu‐like symptoms. This usually happens about two to four weeks after they come in contact with HIV. The symptoms may last for one or two weeks and include: Fever Rash Swollen lymph nodes Feeling tired Joint or muscle pain There are other less common symptoms including: loss of appetite, weight loss, headache, stiff neck, mouth ulcers, thrush, sore throat, nausea/vomiting, diarrhea and abdominal pain. If you are worried about symptoms that might be HIV seroconversion, or about changes in your health, it is important to see a health care provider for testing and diagnosis. Tests & Diagnosis The only way to know for sure if you have HIV is to get a blood test.
    [Show full text]
  • Update on Seroconversion for HIV Infection HIV/STD FACTS HIV/STD FACTS
    Update on Seroconversion for HIV Infection HIV/STD FACTS What is seroconversion (the "window period")? Seroconversion is the length of time after infection that it takes for a person to develop enough specific antibodies to be detected by our current testing methods. This is commonly referred to as the "window period." If an individual engages in unsafe sex or shares drug injection equipment and becomes infected, the body will make antibodies to fight HIV. When enough antibodies are developed, the HIV HIV/STD FACTS antibody test will come back positive. Each person’s body responds to HIV infection a little differently, so the window period varies from person to person. HIV is most commonly diagnosed in adolescents and adults through HIV antibody testing. However, there are also tests that diagnose HIV infection by detecting certain parts of the genetic material of HIV. PCR (polymerase chain reaction) tests are used to diagnose HIV infection in infants. Viral culture may also be performed in certain circumstances to HIV/STD FACTS diagnose HIV. How has our understanding of seroconversion changed over the years? Early in the epidemic, our testing methods were not as sensitive as they are today. Doctors and public health officials wanted to make sure that people who engaged in risk behaviors for HIV were tested long enough after their risk to be sure that anyone who was actually infected would test positive. The Centers HIV/STD FACTS for Disease Control currently states that people with possible exposure to HIV, who test negative, should be re-tested six months after the possible exposure to ensure that sufficient time has elapsed to make antibodies.
    [Show full text]
  • Vaccine 27 (2009) 7326–7330
    Vaccine 27 (2009) 7326–7330 Contents lists available at ScienceDirect Vaccine journal homepage: www.elsevier.com/locate/vaccine Seroconversion, neutralising antibodies and protection in bluetongue serotype 8 vaccinated sheep C.A.L. Oura a,∗, J.L.N. Wood b, A.J. Sanders a, A. Bin-Tarif a, M. Henstock a, L. Edwards a, T. Floyd b, H. Simmons c, C.A. Batten a a Institute for Animal Health, Pirbright Laboratory, Ash Road, Pirbright, Woking, Surrey GU240NF, UK b Cambridge Infectious Diseases Consortium, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK c VLA Weybridge, New Haw, Addlestone, Surrey KT15 3NB, UK article info abstract Article history: Bluetongue virus serotype 8 (BTV-8) has caused a major outbreak of disease in cattle and sheep in several Received 21 July 2009 countries across northern and western Europe from 2006 to 2008. In 2008 the European Union instigated a Received in revised form mass-vaccination programme in affected countries using whole virus inactivated vaccines. We evaluated 15 September 2009 vaccinal responses in sheep and the ability of the vaccine to protect against experimental challenge. Sheep Accepted 15 September 2009 vaccinated 10 months previously under field conditions were challenged with BTV-8. One of 7 vaccinated Available online 26 September 2009 sheep became infected, as evidenced by detection of viral RNA by real-time RT-PCR and by virus isolation. The remaining 6 sheep appeared fully protected from virus replication. None of the vaccinated sheep Keywords: Bluetongue serotype 8 showed clinical signs of BTV and there was a good correlation between the presence of neutralising Inactivated vaccine antibodies on challenge and protection.
    [Show full text]
  • Association of Seroconversion with Isolation of Agents in Transtracheal Wash Fluids Collected from Pneumonic Calves Less Than Three Months of Age
    PEER REVIEWED Association of Seroconversion with Isolation of Agents in Transtracheal Wash Fluids Collected From Pneumonic Calves Less than Three Months of Age 2 3 4 2 5 A.-M.K. Virtala, DVM, PhD • • ; Y.T. Grohn, DVM, MPVM, PhD ; G.D. Mechor, DVM, MVSc ; H.N. Erb, DVM, PhD2; and E.J. Dubovi, PhD2 2Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA 3Department of Microbiology and Epidemiology, Faculty of Veterinary Medicine, P.O. Box 57, 00014 Helsinki University, Finland 4Department of Virology and Epidemiology, Epidemiology and Biotechnology Unit, National Veterinary and Food Research Institute, P. 0. Box 368, 00231 Helsinki, Finland 5Elanco Animal Health, a Division of Eli Lilly and Co, 1024 North Ridge Court, Keller, Texas 76248, USA Corresponding author: Dr. Gerald D. Mechor Abstract ratory tract of clinically pneumonic dairy calves less than 3 months of age. The objective of this study was to investigate the potential association between seroconversion to organ­ Introduction isms important in respiratory disease and isolation from transtracheal wash fluids (TTW) collected from pneu­ The level of the immune response is controlled in monic dairy calves less than 3 months of age. These part by a negative feedback whereby a specific anti­ calves had naturally acquired infections and represented body inhibits further production of more antibody of 18 commercial dairy farms. Each calf had at least one the same specificity. 20 Passive transfer of maternal respiratory pathogen cultured from the TTW, which was antibody also inhibits the development of measurable 4 6 19 20 carried out at the time of clinical diagnosis.
    [Show full text]
  • Mechanisms of Dysregulated Humoral and Cellular Immunity by SARS-Cov-2
    pathogens Review Mechanisms of Dysregulated Humoral and Cellular Immunity by SARS-CoV-2 Nima Taefehshokr 1 , Sina Taefehshokr 2 and Bryan Heit 1,3,* 1 Department of Microbiology and Immunology, Center for Human Immunology, The University of Western Ontario, London, ON N0M 2N0, Canada; [email protected] 2 Immunology Research Center, Tabriz University of Medical Sciences, Tabriz 51368, Iran; [email protected] 3 Robarts Research Institute, London, ON N6A 5K8, Canada * Correspondence: [email protected]; Tel.: +1-519-661-3407 Received: 10 November 2020; Accepted: 6 December 2020; Published: 8 December 2020 Abstract: The current coronavirus disease 2019 (COVID-19) pandemic, a disease caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), was first identified in December 2019 in China, and has led to thousands of mortalities globally each day. While the innate immune response serves as the first line of defense, viral clearance requires activation of adaptive immunity, which employs B and T cells to provide sanitizing immunity. SARS-CoV-2 has a potent arsenal of mechanisms used to counter this adaptive immune response through processes, such as T cells depletion and T cell exhaustion. These phenomena are most often observed in severe SARS-CoV-2 patients, pointing towards a link between T cell function and disease severity. Moreover, neutralizing antibody titers and memory B cell responses may be short lived in many SARS-CoV-2 patients, potentially exposing these patients to re-infection. In this review, we discuss our current understanding of B and T cells immune responses and activity in SARS-CoV-2 pathogenesis.
    [Show full text]
  • Longitudinal Change in the Serology of Antibodies to Chlamydia Trachomatis Pgp3 in Children Residing in a Trachoma Area
    www.nature.com/scientificreports OPEN Longitudinal change in the serology of antibodies to Chlamydia trachomatis pgp3 in children Received: 14 August 2017 Accepted: 25 January 2018 residing in a trachoma area Published: xx xx xxxx Sheila K. West1, Beatriz Munoz1, Hemjot Kaur1, Laura Dize1, Harran Mkocha2, Charlotte A. Gaydos1 & Thomas C. Quinn3 A serologic test for antibodies to chlamydial antigen pgp3 may be a useful tool for trachoma surveillance. However, little is known about the stability of antibody status over time, or factors associated with seroreversion/conversion. A cohort of 2,111 children ages 1–9 years in Tanzania were followed for one year in the absence of mass azithromycin. At baseline and follow-up, they were evaluated for trachoma, chlamydial infection, and antibodies to chlamydial antigen pgp3. At baseline, 31% of children were seropositive for pgp3 antibodies and 6.4% seroreverted to negative over one year. Of those seronegative, 9.8% seroconverted over the year. The seroreverters had lower baseline mean fuorescence intensity (MFI-BG) values compared to the seropositives who remained positive (Odds Ratio = 0.04 for every unit increase in log10MFI-BG, 95% CI = 0.02–0.09), and were more likely to live in communities with trachoma <5% (p < 0.008). While seroconversion was expected, seroreversion was unexpected. The low seroprevalence rate reported from low endemic areas may be due to seroreversion as well as lack of exposure. Trachoma, a chronic conjunctivitis caused by C. trachomatis, is the leading infectious cause of blindness world-wide, although impressive strides towards elimination are being achieved1. Te World Health Organization (WHO) has set a goal of elimination of blinding trachoma as a public health problem by the year 20202.
    [Show full text]
  • FACT SHEET for HEALTHCARE PROVIDERS Coronavirus Genalyte, Inc
    FACT SHEET FOR HEALTHCARE PROVIDERS Coronavirus Genalyte, Inc. October 8, 2020 Disease 2019 Maverick SARS-CoV-2 Multi-Antigen Serology Panel v2 (COVID-19) This Fact Sheet informs you of the significant known and potential risks and benefits of the emergency use of the This test detects human SARS-CoV-2 antibodies Maverick SARS-CoV-2 Multi-Antigen Serology Panel v2. that are generated as part of the human adaptive immune response to the COVID-19 virus and is to be performed on only human dipotassium You should not interpret the results of this test EDTA venous whole blood, dipotassium EDTA as an indication or degree of immunity or plasma and serum specimens. protection from reinfection. your local jurisdiction’s website for the most up to date The Maverick SARS-CoV-2 Multi-Antigen Serology information. Panel v2 is authorized for the detection of antibodies to SARS-CoV-2 in human dipotassium EDTA venous What do I need to know about COVID-19 testing? whole blood, dipotassium EDTA plasma and serum. Current information on COVID-19 for healthcare providers is available at CDC’s webpage, Information for Healthcare Professionals (see links provided in “Where can I go for updates and more information?” section). All individuals whose specimens are tested with this test will receive the Fact Sheet for Recipients: • The Maverick SARS-CoV-2 Multi-Antigen Serology Genalyte, Inc. – Maverick SARS-CoV-2 Multi- Panel v2 can be ordered by healthcare providers to test human dipotassium EDTA venous whole blood, Antigen Serology Panel v2. dipotassium EDTA plasma, and serum to detect if there has been an adaptive immune response to COVID-19, indicating recent or prior infection.
    [Show full text]
  • Atellica IM SARS-Cov-2 Igg (COV2G) 11206997 (100 Tests)
    SARS-CoV-2 IgG (COV2G) For Use Under Emergency Use Authorization Only For in vitro diagnostic use. For prescription use only. The results of this semi-quantitative test should not be interpreted as an indication or degree of immunity or protection from reinfection. Assay for the Detection of IgG Antibodies to SARS-CoV-2 Current Revision and Datea Rev. 01, 2020-07 Product Name Atellica IM SARS-CoV-2 IgG (COV2G) 11206997 (100 tests) 11206998 (500 tests) Abbreviated Product Name Atellica IM COV2G Test Name/ID COV2G Systems Atellica IM Analyzer Materials Required but Not Provided Atellica IM COV2G QC 11206999 Optional Materials Atellica IM Multi-Diluent 12 10995550 (vial) Specimen Types Serum, potassium EDTA plasma, lithium heparin plasma Sample Volume 10 µL Measuring Interval 0.50–20.00 Index a A vertical bar in the page margin indicates technical content that differs from the previous version. Intended Use The Atellica® IM SARS-CoV-2 IgG (COV2G) assay is a chemiluminescent immunoassay intended for qualitative and semi-quantitative detection of IgG antibodies to SARS-CoV-2 in human serum and plasma (potassium EDTA and lithium heparin) using the Atellica® IM Analyzer. The Atellica IM SARS-CoV-2 IgG (COV2G) assay is intended for use as an aid in identifying individuals with an adaptive immune response to SARS-CoV-2, indicating recent or prior infection. At this time, it is unknown for how long antibodies persist following infection and if the presence of antibodies confers protective immunity. The Atellica IM SARS-CoV-2 IgG (COV2G) assay should not be used to diagnose acute SARS-CoV-2 infection.
    [Show full text]