BACKGROUND: HIV-1 p24 antigen assay is useful for the detection of circulating viruses, and infection prior to seroconversion. However, circulating HIV-1 p24 antigen may be complexed with HIV antibody and prevent it from being detected by antigen capture assay. To detect HIV-1 p24 antigen in the specimen, it is necessary to dissociate immune complexes and confirm the presence of HIV-1 p24 antigen after the neutralization with the specific antibody. METHODS: We tested 32 sera from HIV-1 infected persons who were diagnosed from 1987 tO1996 in Korea for HIV-1 p24 antigen by enzyme linked immunosorbent assay (ELISA.) with or without the dissociation of immune complexes. And we confirmed the antigen assay results by the neutralization with HIV-1 specific antibody as a confirmatory test. We also calculated the concentration of HIV-1 p24 antigen in each specimen. RESULTS: Eleven of 32 sera tested were initially positive for HIV-1 p24 antigen. After the dissociation of immune complexes for 29 sera except two of which signal/cutoff ratios were higher than 7.0 and except one which was not enough for the assay,13 were shown to be positive for HIV-1 p24 antigen and their signal/cutoff ratios were increased by 10 times. Five of antigen negative cases were turned to be positive after the immune complex dissociation. After neutralization with HIV-1specific p24 antibody for sera of 13 which were positive for HIV-1 p24 antigen with or without the immune complex dissociation, all were shown to be neutralized. We have observed more than 90% neutralization reduction for 12 sera and more than 50% less than 90% for one. The average concentration of HIV-1 p24 antigen was8.76pg/ml by antigen assay and was increased to 76.81~g/m~ after immune complex dissociation. CONCLUSION: We concluded that the sensitivity and the specificity of HIV-1 p24 antigen assay could be increased by dissociation of the immune complexes and neutralization with the specific antibody.
Antigen-Antibody Complex* ; Enzyme-Linked Immunosorbent Assay ; HIV ; HIV-1* ; Humans ; Korea* ; Sensitivity and Specificity

No abstract available.

Understanding of the surgical anatomy of patients with double outlet right ventricle (DORV) is important in the planning of biventricular repair. From May 1995 to September 1996, 7 patients underwent biventricular repair for DORV with remote ventricular septal defect. There were 5 males and 2 females. Age at operation varied from 2 to 9 years(mean 3.4+/-2.7years). Preoperative diagnostic assessment was made by two-dimensional echocardiography and cardiac catheterization. Ventricular septal defect was perimembranous inlet type in all patients. Associated cardiac anomalies were pulmonary atresia in two, pulmonary stenosis in five and tricuspid chordae attachment to conal septum in five. The operations were performed intraventricular repair and pulmonary enlargement in two, REV operation in two, and Rastelli operation in three. There was no early postoperative deaths and complications. The follow-up period was from 1 month to 18months, averaging 10+/-6.1 months. In the past,we considered the Fontan operation indicative as primary choice when DORV was associated with abnormal tricuspid chordal attachment to the conal septum,but now we believe that biventricular repair is feasible for those cases by making conal flap or reattachment method. Biventricular repair has theoretic advantages because it estabilishes normal anatomy and physiology,and it was concluded that the precise preoperative evaluation using both echocardiography and cardiac catheterization was essential to the successful surgery.
Bays ; Cardiac Catheterization ; Cardiac Catheters ; Double Outlet Right Ventricle* ; Echocardiography ; Female ; Follow-Up Studies ; Fontan Procedure ; Heart Septal Defects, Ventricular* ; Humans ; Male ; Pulmonary Atresia ; Pulmonary Valve Stenosis