North Carolina researchers say nucleic test can detect HIV infections earlier

North Carolina researchers say they've developed a sophisticated test that can save lives by detecting HIV infections weeks earlier than the standard screening. The test catches HIV cases when people are most contagious--in the days immediately after infection, when the virus is growing rampantly and before the immune system has formed antibodies that current tests pick up, says researchers at the University of North Carolina and the state health department. Earlier detection could lead to lower infection rates, the scientists reported, eliminating a gap between infection and diagnosis when people unknowingly pass the virus to sex partners. "This tool will provide an opportunity for us to fight the epidemic in real time," said Leah Devlin, state health director. "We can go from a point of testing to follow-up care to treatment within 48 hours. That's a lot of energy, but I'm telling you, that's going to save lives." The New England Journal of Medicine published the results of the research Thursday. Testing 109,250 patients between November 2002 and October 2003, the scientists identified 583 HIV-positive people with the standard antibody test alone. But when they ran the more sophisticated test--called nucleic acid amplification--on all the negative samples from the usual screening, they caught an additional 23 cases. Additionally, after interviewing those who were newly infected, doctors and public health workers found 18 more people--mainly sex partners of the 23 new patients--who tested positive. One pregnant woman also was identified as newly infected with HIV, allowing doctors to give her a course of antiretroviral drugs to block transmission to her baby, said Peter Leone, a principal author of the study. Two other pregnant women with HIV have since been identified, he said. "That's saving the system several hundred thousand dollars" by sparing a child from infection and the subsequent lifelong treatments, said Leone, a UNC professor and medical director of the state agency that oversees HIV prevention. Since the trial ended, the state has continued to provide nucleic acid testing to people who request an HIV antibody test, Leone said. North Carolina is the only state to do so, at a cost of about $450,000 in laboratory expenses, or $3.63 per test. Leone and Christopher Pilcher, a UNC professor and lead author of the study, said they are continuing to gather data and also are studying whether treatment is more effective if it's started in the early days of infection. Those studies will take years before results can be noted. (AP)