β2-microglobulin, HIV-1 p24 antibody and acid-dissociated HIV-1 p24 antigen levels: Predictive markers for vertical transmission of HIV-1 in pregnant Ugandan women

J. Brooks Jackson, Peter Kataaha, David L. Hom, Francis Mmiro, Laura Guay, Christopher Ndugwa, Lawrence Marum, Estelle Piwowar, Karen Brewer, Gary Toedter, David Hofheinz, Karen Olness

Research output: Contribution to journalArticle

Abstract

Objectives: To evaluate the clinical utility of plasma β2-microglobulin (β2M) levels, acid-dissociated HIV-1 p24 antigen, and HIV-1 p24-antibody titers in predicting HIV-1 vertical transmission in 227 HIV-1-infected Ugandan pregnant women. Design: Plasma β2M levels, acid-dissociated HIV-1 p24-antigen positivity, and HIV-1 p24-antibody titers were determined using commercial enzyme immunoassays (EIA) in a Ugandan cohort of 52 HIV-1-seropositive transmitting mothers, 175 HIV-1-seropositive non-transmitting mothers, and 52 seronegative mothers within 6 weeks prior to delivery. Results: Transmitter mothers had significantly higher plasma concentrations of β2M (1.80 ± 1.13mg/l) than non-transmitter seropositive mothers (1.32 ± 0.81 mg/l; P=0.0013). Similarly, a significantly higher proportion of transmitter mothers had detectable p24 antigen than non-transmitter mothers [six out of 51 (11.8%) versus six out of 173 (3.5%); P=0.03]. Compared with the vertical transmission rate of 23% in the seropositive group, the positive predictive values of a β2M level > 1.5 mg/l or detectable HIV-1 p24 antigen for vertical transmission were 34 and 50%, respectively. Five of six (83.3%) seropositive mothers with both a β2M level > 1.5 mg/l and detectable p24 antigenemia transmitted HIV-1 infection to their infants compared with 25 of 124 (20.2%) seropositive mothers with values below the cut-off values for both tests (P=0.00249). However, β2M was not found to be a significant independent predictor of vertical transmission when analyzed in a multivariate model with p24 antigenemia. There was no significant difference in HIV-1 p24-antibody titers in transmitter mothers versus non-transmitter mothers (P=0.299). Conclusion: β2M levels and acid-dissociated HIV-1 p24-antigen assays may be used to predict which HIV-1-infected pregnant women are at greatest risk for vertical transmission. However, only the p24-antigen test was independently predictive of vertical transmission and its clinical utility is limited.

Original languageEnglish (US)
Pages (from-to)1475-1479
Number of pages5
JournalAIDS
Volume7
Issue number11
StatePublished - Nov 1993
Externally publishedYes

Keywords

  • β-microglobulin
  • HIV-1
  • p24 antibody
  • p24 antigen
  • Uganda
  • Vertical transmission

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

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    Jackson, J. B., Kataaha, P., Hom, D. L., Mmiro, F., Guay, L., Ndugwa, C., Marum, L., Piwowar, E., Brewer, K., Toedter, G., Hofheinz, D., & Olness, K. (1993). β2-microglobulin, HIV-1 p24 antibody and acid-dissociated HIV-1 p24 antigen levels: Predictive markers for vertical transmission of HIV-1 in pregnant Ugandan women. AIDS, 7(11), 1475-1479.