Current serological tests for HIV screening and confirmation of infection present challenges to the adoption of HIV vaccines. The detection of vaccine-induced HIV-1 antibodies in the absence of HIV-1 infection, referred to as vaccine-induced seropositivity/seroreactivity, confounds the interpretation of test results, causing misclassification of HIV-1 status with potential affiliated stigmatization. For HIV vaccines to be widely adopted with high community confidence and uptake, tests that are agnostic to vaccination status (i.e., only positive for true HIV-1 infection) of tested individuals are needed. Successful development and deployment of such tests will require HIV vaccine developers to work in concert with diagnostic developers. Such tests will need to match today’s high-performance standards (accuracy, cost-effectiveness, simplicity) for use in both vaccinated and unvaccinated populations, especially in low- and middle-income countries with high HIV burden. Herein, we discuss the challenges and strategies for developing modified serological HIV tests for concurrent deployment with HIV vaccines.

中文翻译：

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HIV 诊断和疫苗：两个人一起探戈

目前用于艾滋病毒筛查和感染确认的血清学测试对艾滋病毒疫苗的采用提出了挑战。在没有 HIV-1 感染的情况下检测疫苗诱导的 HIV-1 抗体（称为疫苗诱导的血清阳性/血清反应性）会混淆检测结果的解释，导致 HIV-1 状态的错误分类以及潜在的相关污名。为了使 HIV 疫苗得到广泛采用并具有较高的社区信心和接受度，需要对受试个体的疫苗接种状态（即仅对真正的 HIV-1 感染呈阳性）进行不可知的测试。此类测试的成功开发和部署需要艾滋病毒疫苗开发商与诊断开发商合作。此类测试需要符合当今的高性能标准（准确性、成本效益、简单性），以便在接种疫苗和未接种疫苗的人群中使用，特别是在艾滋病毒负担较高的低收入和中等收入国家。在此，我们讨论了开发改进的 HIV 血清学检测以与 HIV 疫苗同时部署的挑战和策略。