Performance of Galectin-9 for Identification of HIV Viremia in Adults Receiving Antiretroviral Therapy in a Resource-Limited Setting
(2023) In Journal of Acquired Immune Deficiency Syndromes 93(3). p.244-250- Abstract
Background: Targeted viral load (VL) testing has been proposed for antiretroviral treatment (ART) monitoring in resource-limited settings. In this study, we have investigated the performance of the host biomarker galectin-9 (Gal-9), alone and in combination with interferon-γ-inducible protein 10 (IP-10), in identifying individuals at increased likelihood of viremia during ART.Setting:Cohort of HIV-positive adults receiving ART at Ethiopian health centers.Methods:We included participants with detectable viremia (VL ≥150 copies/mL) 12 months after starting ART and sex-matched nonviremic controls. Performance to identify individuals with VL ≥1000 copies/mL was determined for Gal-9 and the Gal-9/IP-10 combination, respectively, using... (More)
Background: Targeted viral load (VL) testing has been proposed for antiretroviral treatment (ART) monitoring in resource-limited settings. In this study, we have investigated the performance of the host biomarker galectin-9 (Gal-9), alone and in combination with interferon-γ-inducible protein 10 (IP-10), in identifying individuals at increased likelihood of viremia during ART.Setting:Cohort of HIV-positive adults receiving ART at Ethiopian health centers.Methods:We included participants with detectable viremia (VL ≥150 copies/mL) 12 months after starting ART and sex-matched nonviremic controls. Performance to identify individuals with VL ≥1000 copies/mL was determined for Gal-9 and the Gal-9/IP-10 combination, respectively, using receiver operating characteristic (ROC) analysis.Results:Among 191 participants (50.3% women), 46 (24.1%) had VL ≥1000 copies/mL, 23 (12.0%) had 150-999 copies/mL, and 122 (63.9%) had <150 copies/mL. Gal-9 and VL were positively correlated (rs= 0.451, P < 0.001). Sensitivity and specificity for Gal-9 to identify individuals with VL ≥1000 copies/mL were 91.3% (95% CI: 79.2-97.6) and 54.5% (95% CI: 46.0-62.8), respectively. The area under the ROC curve for Gal-9 was 0.810 (95% CI: 0.745-0.875), which was similar to that of the combination of Gal-9 and IP-10 [0.849 (95% CI: 0.792-0.905)]. Assuming 10% prevalence of VL ≥1000 copies/mL, using Gal-9 for targeted VL testing instead of universal VL testing would reduce the number of VL tests from 10 to 5 to identify 1 viremic individual, with misclassification of 1 in 10 viremic individuals.Conclusions:Gal-9 is a potential screening marker for targeted VL monitoring in ART recipients. Further studies are needed to determine optimal threshold levels.
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- author
- Thorman, Johannes LU ; Björkman, Per LU ; Sasinovich, Sviataslau LU ; Tesfaye, Fregenet ; Mulleta, Daba ; Medstrand, Patrik LU and Reepalu, Anton LU
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- antiretroviral treatment, galectin-9, HIV, interferon-γ-inducible protein 10, screening marker, viral load
- in
- Journal of Acquired Immune Deficiency Syndromes
- volume
- 93
- issue
- 3
- pages
- 7 pages
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- scopus:85163189937
- pmid:36961948
- ISSN
- 1525-4135
- DOI
- 10.1097/QAI.0000000000003196
- language
- English
- LU publication?
- yes
- id
- d63c039a-8106-4fba-b17b-1e707e2dd60f
- date added to LUP
- 2023-09-13 12:26:02
- date last changed
- 2024-07-13 10:46:21
@article{d63c039a-8106-4fba-b17b-1e707e2dd60f, abstract = {{<p>Background: Targeted viral load (VL) testing has been proposed for antiretroviral treatment (ART) monitoring in resource-limited settings. In this study, we have investigated the performance of the host biomarker galectin-9 (Gal-9), alone and in combination with interferon-γ-inducible protein 10 (IP-10), in identifying individuals at increased likelihood of viremia during ART.Setting:Cohort of HIV-positive adults receiving ART at Ethiopian health centers.Methods:We included participants with detectable viremia (VL ≥150 copies/mL) 12 months after starting ART and sex-matched nonviremic controls. Performance to identify individuals with VL ≥1000 copies/mL was determined for Gal-9 and the Gal-9/IP-10 combination, respectively, using receiver operating characteristic (ROC) analysis.Results:Among 191 participants (50.3% women), 46 (24.1%) had VL ≥1000 copies/mL, 23 (12.0%) had 150-999 copies/mL, and 122 (63.9%) had <150 copies/mL. Gal-9 and VL were positively correlated (r<sub>s</sub>= 0.451, P < 0.001). Sensitivity and specificity for Gal-9 to identify individuals with VL ≥1000 copies/mL were 91.3% (95% CI: 79.2-97.6) and 54.5% (95% CI: 46.0-62.8), respectively. The area under the ROC curve for Gal-9 was 0.810 (95% CI: 0.745-0.875), which was similar to that of the combination of Gal-9 and IP-10 [0.849 (95% CI: 0.792-0.905)]. Assuming 10% prevalence of VL ≥1000 copies/mL, using Gal-9 for targeted VL testing instead of universal VL testing would reduce the number of VL tests from 10 to 5 to identify 1 viremic individual, with misclassification of 1 in 10 viremic individuals.Conclusions:Gal-9 is a potential screening marker for targeted VL monitoring in ART recipients. Further studies are needed to determine optimal threshold levels.</p>}}, author = {{Thorman, Johannes and Björkman, Per and Sasinovich, Sviataslau and Tesfaye, Fregenet and Mulleta, Daba and Medstrand, Patrik and Reepalu, Anton}}, issn = {{1525-4135}}, keywords = {{antiretroviral treatment; galectin-9; HIV; interferon-γ-inducible protein 10; screening marker; viral load}}, language = {{eng}}, number = {{3}}, pages = {{244--250}}, publisher = {{Lippincott Williams & Wilkins}}, series = {{Journal of Acquired Immune Deficiency Syndromes}}, title = {{Performance of Galectin-9 for Identification of HIV Viremia in Adults Receiving Antiretroviral Therapy in a Resource-Limited Setting}}, url = {{http://dx.doi.org/10.1097/QAI.0000000000003196}}, doi = {{10.1097/QAI.0000000000003196}}, volume = {{93}}, year = {{2023}}, }