Pattern and Frequency of Seroreactivity to Routinely Used Serologic Tests in Early-Treated Infants With HIV
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
Authors: Puthanakit, Thanyawee; Ananworanich, Jintanat; Akapirat, Siriwat; Pattanachaiwit, Supanit; Ubolyam, Sasiwimol; Assawadarachai, Vatcharain; Sawangsinth, Panadda; Jupimai, Thidarat; Anugulruengkitt, Suvaporn; Tawan, Monta; Kosalaraksa, Pope; Borkird, Thitiporn; Suntarattiwong, Piyarat; Kanjanavanit, Suparat; de Souza, Mark S.
Abstract
Background: Previous studies have shown low frequencies of seroreactivity to HIV diagnostic assays for infected infants treated with antiretroviral therapy (ART) early in infection. Methods: Fifty-eight HIV-infected infants treated with ART at a median age of 1.9 months (range: 0.2-5.4) for up to 4 years of life were assessed for seroreactivity to 4 routinely used HIV clinical immunoassays (IA): Second-generation (2ndG) IA and 2 rapid diagnostic tests (RDT), based on third-generation principles, measuring antibody only and a fourth-generation (4thG) antigen/antibody IA. HIV Western blot assay was also performed to assess HIV-specific antibodies. Results: The 2ndG IA demonstrated the highest frequency of seroreactivity in children (69%) followed by the 4thG IA (40%) and the RDT (26%) after one year of ART. Infants initiating ART during ages 3-6 months (N = 15) showed a greater frequency (range: 53%-93%) and breadth (median and range: 3 [1-4]) of reactivity across the assays compared with those treated within 3 months (N = 43):16%-61% and breadth (1 [0-4]). The 4thG IA showed significantly reduced reactivity relative to the 2ndG IA at one (P = 0.016) and 3 (P = 0.004) years of ART. Western blot profiles following 3 years of ART showed the highest frequency of reactivity to HIV Gag p24 (76%) and lowest reactivity to Env gp120 and gp41, with only 24% of children confirmed positive by the assay. Conclusions: These results suggest that the use of 4thG IA and RDT test combination algorithms with limited HIV antigen breadth may not be adequate for diagnosis of HIV-infected children following early treatment.
A survey of core replacements in indole-based HIV-1 attachment inhibitors
BIOORGANIC & MEDICINAL CHEMISTRY LETTERS
Authors: Wang, Tao; Wallace, Owen B.; Zhang, Zhongxing; Fang, Haiquan; Yang, Zhong; Robinson, Brett A.; Spicer, Timothy P.; Gong, Yi-Fei; Blair, Wade S.; Shi, Pei-Yong; Lin, Pin-Fang; Deshpande, Milind; Meanwell, Nicholas A.; Kadow, John F.
Abstract
Indole- and azaindole-based glyoxylyl amide derivatives have been described as HIV-1 attachment inhibitors (AIs) that act by blocking the interaction between the viral gp120 coat protein and the human host cell CD4 receptor. As part of an effort to more deeply understand the role of the indole/azaindole heterocycle in the expression of antiviral activity, a survey of potential replacements was conducted using parallel synthesis methodology. The design and optimization was guided by a simple 2-dimensional overlay based on an overall planar topography between the indole/azaindole and C-7 substituents that had been deduced from structure-activity studies leading to the discovery of temsavir (3). 2-Substituted naphthalene- and quinoline-derived chemotypes emerged as the most interesting prototypes, with C-5 and C-6 substituents enhancing antiviral potency. Despite the fact that neither of these chemotypes incorporated a H-bond donor that has been shown to engage the side chain carboxylate of Asp(113) in gp120, the antiviral potency of several analogues met or exceeded that of 3, demonstrating that engaging Asp(113) is not a prerequisite for potent antiviral activity.