Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
THE IMMUNE SYSTEM: SEROLOGY AND APPLICATIONS
The Epidemiology of AIDS: Expression, Occurrence, and Control of Human Immunodeficiency Virus Type 1 Infection. Kaslow RA and Francis DP, eds. New York, Oxford University Press, p. 42-7, 1989.. Unique Identifier : AIDSLINE ICDB/90668110 Ascher MS; Kaslow RA; California Dept. of Health, Rm. 454, 2151 Berkeley Way, Berkeley,; CA 94704
Abstract:
HIV-1 infection and AIDS are unusual among infectious diseases in that the presence of antibodies to HIV-1 signifies active infection and infectiousness with few if any exceptions. In other infections, antibodies confer immunity and resistance to further challenge. This serologic phenomenon is advantageous to public health practice because a straightforward blood test can nearly always detect infected individuals. At the same time, it is devastating to the infected individual because it implies the absence of protective immunity. Serologic considerations in HIV-1 infection are reviewed, including HIV-1 antibody tests, supplemental tests, role of the second specimen, HIV-1 antigen testing, and new technology. The most commonly used test, automated for screening large numbers of samples, is the enzyme-linked immunoassay (EIA) test. The test is a standard indirect anti-antibody procedure using antigen in the form of viral lysate coupled to a solid phase (eg, plastic). Seven manufacturers in the United States market kits for screening of blood and diagnosis. Supplemental tests are often used as a matter of standard laboratory practice. The immunoblot test (Western blot) has become an important adjunct in identifying persons who are truly seropositive. False-positive tests occur in no more than 0.001% of sera routinely screened using EIA and immunoblot methods in sequence. Major advances in testing are likely to occur in the use of (bio)synthetic antigens for screening and supplemental assays. Methods based on recombinant DNA technology or small synthetic peptides (10-20 amino acids) have been developed. Rapid, low-technology tests for use in the physician's office or in less-developed countries are on the horizon. HIV-1 antibody testing is probably the most accurate blood test ever used. Developed on short notice, the kits have virtually eliminated the risk of transfusion-associated AIDS in the developed world. (45 Refs)
Keywords: Acquired Immunodeficiency Syndrome/DIAGNOSIS/*IMMUNOLOGY AIDS Serodiagnosis/METHODS Gene Products, gag/ANALYSIS Human HIV Antibodies/*ANALYSIS HIV Infections/DIAGNOSIS/*IMMUNOLOGY HIV Seropositivity/IMMUNOLOGY HIV-1/*IMMUNOLOGY Viral Core Proteins/ANALYSIS MONOGRAPH REVIEW
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Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
