Original Research

HIV-1/2 differentiation in a South African public laboratory

Rendani T. Mafuyeka, Lynne M. Webber, Piet Becker, Simnikiwe H. Mayaphi
Southern African Journal of HIV Medicine | Vol 22, No 1 | a1185 | DOI: https://doi.org/10.4102/sajhivmed.v22i1.1185 | © 2021 Rendani T. Mafuyeka, Lynne M. Webber, Piet Becker, Simnikiwe H. Mayaphi | This work is licensed under CC Attribution 4.0
Submitted: 26 October 2020 | Published: 12 March 2021

About the author(s)

Rendani T. Mafuyeka, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Lynne M. Webber, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria; Department of Virology, Tshwane Academic division, National Health Laboratory, Pretoria, South Africa
Piet Becker, Research Office, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Simnikiwe H. Mayaphi, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa


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Abstract

Background: The human immunodeficiency virus type-2 (HIV-2) prevalence in South Africa (SA) is unknown, however, sporadic cases have been reported. Human immunodeficiency virus -1 and 2 differentiation is not part of most South African public laboratories’ testing algorithm. Human immunodeficiency virus -2 diagnosis using serology assays may be complicated by HIV-1 and HIV-2 antibody cross-reactivity.

Objectives: To determine the proportion of HIV-2 infections in specimens that tested HIV-1/2 positive at a public laboratory in Tshwane.

Method: A total of 480 specimens that were previously tested with fourth generation ELISA platforms (Modular E170 [Roche, Switzerland] and Architect i2000 [Abbott, Germany]) were randomly selected. Human immunodeficiency virus -1 and 2 antibody differentiation testing was carried out using the Multispot HIV-1/2 rapid assay (Bio-Rad Laboratories, USA). An in-house nested HIV-2 PCR assay targeting the 5′-long terminal repeats (5′-LTR) region was evaluated and used as a confirmatory test.

Results: The study tested 480 HIV-1/2 seropositive patients and their mean age was 36.7 years (range 3–82 years). Of the 480 patients, 292 (60.8%) were female, 182 (37.9%) were male and 6 (1.3%) were not specified. Human immunodeficiency virus differentiation results were as follows: 466 (97.1%) were positive for only HIV-1 antibodies, 11 (2.3%) [95%CI: (0.98%; 3.74%)] were positive for both HIV-1 and HIV-2 antibodies, 3 (0.6%) were negative for both antibodies and none were positive for only HIV-2 antibodies. Of the 11 specimens with both HIV-1 and HIV-2 antibodies, seven had sufficient volume for confirmatory testing and were all negative on the in-house HIV-2 PCR assay.

Conclusion: The multispot HIV-1/2 rapid assay demonstrated cross-reactivity between HIV-1 and HIV-2 antibodies. Human immunodeficiency virus -2 infections were not detected.


Keywords

HIV-1/2 differentiation; HIV-2 testing; HIV1/2 antibody cross reaction; HIV-2 in South Africa; HIV-2 PCR

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