Human Immunodeficiency Virus (HIV) types Western blot (WB) band profiles as potential surrogate markers of HIV disease progression and predictors of vertical transmission in a cohort of infected but antiretroviral therapy naive pregnant women in Harare, Zimbabwe

Este artículo es muy interesante, espero que lo disfruten.
Saludos

Dr. Carlos Erazo


"Abstract
Background: Expensive CD4 count and viral load tests have failed the intended objective of
enabling access to HIV therapy in poor resource settings. It is imperative to develop simple,
affordable and non-subjective disease monitoring tools to complement clinical staging efforts
of inexperienced health personnel currently manning most healthcare centres because of brain
drain. Besides accurately predicting HIV infection, sequential appearance of specific bands of
WB test offers a window of opportunity to develop a less subjective tool for monitoring
disease progression.
Methods: HIV type characterization was done in a cohort of infected pregnant women at 36
gestational weeks using WB test. Student-t test was used to determine maternal differences in
mean full blood counts and viral load of mothers with and those without HIV gag antigen
bands. Pearson Chi-square test was used to assess differences in lack of bands appearance
with vertical transmission and lymphadenopathy.
Results: Among the 64 HIV infected pregnant women, 98.4 % had pure HIV-1 infection and
one woman (1.7%) had dual HIV-1/HIV-2 infections. Absence of HIV pol antigen bands was
associated with acute infection, p=0.002. All women with chronic HIV-1 infection had
antibody reactivity to both the HIV-1 envelope and polymerase antigens. However, antibody
reactivity to gag antigens varied among the women, being 100%, 90%, 70% and 63% for p24,
p17, p39 and p55, respectively. Lack of antibody reactivity to gag p39 antigen was associated
with disease progression as confirmed by the presence of lymphadenopathy, anemia, higher
viral load, p=0.010, 0.025 and 0.016, respectively. Although not statistically significant,
women with p39 band missing were 1.4 times more likely to transmit HIV-1 to their infants.Conclusion: Absence of antibody reactivity to pol and gag p39 antigens was associated with
acute infection and disease progression, respectively. Apart from its use in HIV disease
diagnosis, WB test could also be used in conjunction with simpler tests like full blood counts
and patient clinical assessment as a relatively cheaper disease monitoring tool required prior
to accessing antiretroviral therapy for poor resource settings. However, there is also need to
factor in the role of host-parasite genetics and interactions in disease progression."
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http://www.biomedcentral.com/content/pdf/1471-2334-11-7.pdf