Sandeep Ramalingam

Rapid Particle Agglutination Test for Human Immunodeficiency Virus: Hospital-Based Evaluation

ABSTRACT The performance of a rapid particle agglutination test for human immunodeficiency virus (HIV) (Capillus HIV type 1 [HIV-1]/HIV-2) on hospital samples is compared with enzyme-linked immunosorbent assays. The test had a sensitivity and specificity of 99 and 98.9%, respectively. In addition, the test was reactive on plasma samples from all individuals infected with HIV-1 subtype C. This test can safely be used for voluntary counseling and testing in India.

Molecular Confirmation of Human Immunodeficiency Virus (HIV) Type 2 in HIV-Seropositive Subjects in South India

ABSTRACT Nested PCRs for human immunodeficiency virus type 1 (HIV-1) and HIV-2 were compared with immunoblot test results. Twelve of 13 immunoblot-positive HIV-2 samples were positive by PCR. There were five INNO-LIA (Innogenetics, Zwijnaarde, Belgium) and/or HIVBLOT 2.2 (Genelabs, Singapore) samples that tested positive for dual infection. HIV-1 PCR was positive in all samples, while HIV-2 PCR was positive in two and RIBA (Chiron Corporation, San Diego, Calif.) was positive for HIV-2 in three samples. Thus the prevalence of HIV-2 is accurately estimated by the use of immunoblotting, but that of HIV-1 and -2 dual infection may be overestimated.

Prevalence of HIV infection in psychiatric patients attending a general hospital in Tamil Nadu, South India

An anonymous, unlinked study was conducted to detect antibodies to HIV-1 or HIV-2 infections in 1,160 consecutive, newly registered, adult psychiatric outpatients at a general hospital in South India to determine whether psychiatric patients presenting to general hospitals are a population at high risk for HIV infection and should be routinely screened. The seroprevalence of HIV infection (12/1160; 1.03%; 95% CI=0.4-1.6%) did not approximate rates expected of a high-risk group compared to the national (0.7%) or regional community (1.8%) prevalence. It did not differ significantly from HIV seroprevalence in non-psychiatric patients (233/35450; 0.7%; 95% CI=0.57-0.74%) who were systematically screened (relative risk=1.57; 95% CI=0.88-2.80) during the same period, but was greater than the seroprevalence in healthy blood donors (0.5%; p=0.02; relative risk=2.15 95% CI=1.17-3.95). Non-psychiatric patients were also more likely to be HIV infected than blood donors (p=0.02; relative risk=1.37; 95% CI=1.05-1.78). These findings have implications for HIV testing policies among psychiatric and non-psychiatric patients presenting to general hospitals in India.

Correlation of CD4+ T-Cell Counts Estimated by an Immunocapture Technique (Capcellia) with Viral Loads in Human Immunodeficiency Virus-Seropositive Individuals

ABSTRACT As antiretroviral therapy becomes more affordable, valid, reliable, and inexpensive laboratory tests are also needed to monitor the progression of disease in people with human immunodeficiency virus (HIV) infection. The CD4+ T-cell counts estimated by Capcellia, an immunocapture method, and flow cytometry were compared and were correlated with HIV type 1 (HIV-1) load. There was a significant negative correlation between the HIV-1 load and CD4+ T-cell counts estimated by flow cytometry (r = −0.63, P = <0.001) as well as between the HIV-1 load and CD4+ T-cell counts estimated by Capcellia (r = −0.61,P = <0.001). Capcellia is a cost-effective, user-friendly assay that correlated well with HIV-1 load determinations for individuals both with and without treatment.

Hospital-Based Evaluation of Two Rapid Human Immunodeficiency Virus Antibody Screening Tests

Two rapid human immunodeficiency virus (HIV) screening assays, HIV TRI-DOT and HIV-SPOT were compared with standard enzyme-linked immunosorbent assays according to a testing algorithm. Sensitivities and specificities in the real-time evaluation were 99.5 and 99.9% for TRI-DOT and 98.2 and 99.7% for HIV-SPOT, respectively. These two tests are suitable for use where facilities and laboratory expertise are limited.

Human T lymphotrophic virus-I (HTLV-I) infection in patients with unclassifiable dermatitis in central Kerala, south India: a preliminary study

OBJECTIVE We have conducted a preliminary serostudy to confirm the presence of this virus in cases of dermatitis of unknown aetiology and among individuals with sexually transmitted infections (STI) in central Kerala. METHODS 45 consecutive patients who attended the dermatology clinic of Medical College Kottayam with extensive dermatitis that could not be clinically classified into any known clinical entity and 37 consecutive patients who presented to the sexually transmitted disease (STD) clinic were enrolled for the study. Serum/plasma samples were screened for anti-HTLV-I antibody. Reactive and indeterminate samples were confirmed by an immunoblot. RESULTS Among 37 STD clinic attendants, none had antibody to HTLV-I while two individuals (4.44%) among the 45 with dermatitis had antibody to HTLV-I. CONCLUSIONS Our study proves the presence of HTLV-I in a subset of individuals with poorly defined dermatitis in Kerala. Further larger studies are necessary to assess the extent of this problem and its relation to STI in Kerala.

Evaluation of two rapid HIV screening tests for the detection of HIV-2 antibody.

Most of the imported and the few indigenous simple rapid devices and enzyme- linked immunosorbent assays (ELISA) available on the Indian market are evaluated extensively for the detection of HIV-1 infections. However there are no published reports on the evaluation of these kits specifically for the detection of HIV-2 infections from this region. This letter to the editor summarizes an evaluation of two rapid screening assays for HIV antibody in serum or plasma samples is reported: Capillus HIV-1/HIV-2 and HIV TRIDOT. These tests were evaluated on three categories of plasma samples including commercial HIV-ELISA immunoblot and a HIV-2 specific peptide ELISA that categorized the HIV status of the samples. The investigations used blood samples from Indian patients and were tested at the laboratories in India. Overall the rapid test for the diagnosis of HIV infection is very cost-effective and is useful in centers where facilities are limited. In areas like the Indian subcontinent where epidemics of both HIV-1 and HIV-2 infections exist it is important to use tests that can detect both these viruses.

Absence of antibody to HTLV-1 in sera of Asian Indian patients with systemic autoimmune rheumatic diseases.

I Goodfriend, M. Malnutrition: Haitian children and their parents. Clin Pediatr 1999;38:256---7 2 RawsonIG, Berggren G. Familystructure, child location and nutritional disease in rural Haiti. J Trop Ped Environ Child Health 1973;3:288-98 3 Strickland TG. Hunters Tropical Medicine. Philadelphia: WB Saunders, 1991:913-17 4 Farmer AP. Malnutritionas an ecological problem. E Afr Med J 1960;37:399-404 5 Goodall J. Emotionally induced illness in East African Children. E Afr Med J 1972;49:407-18 6 Bouville JF. Aspects relationnels de la malnutritioninfantile en milieu urbain Africain. Cah Sante 1993;3:433-40 7 Management of Severe Malnutrition: a Manual for Physicians and Other Health Workers. Geneva: World Health Organization, 1999:22-3

Infection with human T cell lymphotropic virus 1 (HTLV-1).

asked is what becomes of the holes made on the patients head. The answer is that the cosmetic defect is negligible.) I do not introduce rubber catheter into the recesses of the subdural space to irrigate for fear of causing trauma to the surface of the brain and provoking bleeding away from the burr hole. Neither do I not close the dura, so the haemostasis in the scalp must be meticulous. All bleeding vessels are coagulated and the scalp closed with interrupted, vertical mattressed, non-absorbable sutures with the attainment of a dry scalp at the end of the operation. This obviates the need to leave a drain in the subgaleal space. The surgeon should resist the temptation of using few widely placed sutures in the scalp closure as practised on the abdominal wall. A firm, full-head dressing is applied. Adelola Adeloye FRCS FRCP