Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
DETECTION OF HIV ANTIGEN(S)
HIV Detection by Genetic Engineering Methods. Luciw PA and Steimer KS, eds. New York, Marcel Dekker, p. 195-207, 1989.. Unique Identifier : AIDSLINE ICDB/90660262 Paul DA; Abbott Laboratories, North Chicago, IL
Abstract:
When HIV was identified as the causative agent of AIDS, diagnostic tests were developed to detect antibody (Ab) to HIV. These tests determine that an individual was exposed to the virus sometime in the past, but provide no information on when initial infection may have occurred, whether the virus is present in an active or latent state, or the prognosis for the patient (pt). Complementary testing for HIV antigen (Ag) in serum or plasma might help answer some of these questions, but could be difficult for several reasons. An assay system for HIV Ag was designed using cultured virus as an Ag standard, and three approaches were used to look for HIV Ag: (1) serum, plasma, and other body fluids of infected pts were examined for HIV Ag; (2) peripheral blood lymphocytes (PBLs) as the reservoir of virus were isolated and tested for Ag; and (3) a procedure was developed to precipitate immune complexes from serum, to separate Ag from Ab, and to test for specific HIV Ag. This system is described along with results obtained with alternative approaches, and the possible diagnostic significance of the presence of HIV Ag in serum is discussed. Topics include HIV Ag enzyme immunoassay and its sensitivity and specificity, early HIV infection, diagnostic marker of disease progression, monitoring antiviral therapy, maternal transmission and HIV infection in children, HIV Ag PBLs, and HIV Ag and Ab in immune complexes. The Ag system detected HIV Ag in serum, plasma, and other fluids. HIV Ag can be found in serum prior to Ab seroconversion in early HIV infection and may be useful in diagnosing acute HIV infection. The existence of HIV Ag+/Ab- samples raises the issue of whether Ag testing should be added to current donor-screening tests. There is an increase in the prevalence of antigenemia with disease progression. However, not all pts with AIDS are HIV-Ag positive. This may be explained by fluctuations in Ag levels over time in some pts, possibly reflecting fluctuations in viral expression. It appears that the presence of HIV Ag in asymptomatic, Ab-positive persons identifies an individual who is at increased risk for developing AIDS. It may be this group that would benefit most from an effective treatment when one is identified. The Ag assay is useful in monitoring antiviral therapy in vivo and in vitro and has provided new data concerning maternal transmission of HIV and HIV infection in neonates and children. (28 Refs)
Keywords: Acquired Immunodeficiency Syndrome/DIAGNOSIS AIDS Serodiagnosis/*METHODS AIDS-Related Complex/DIAGNOSIS Female Human HIV/*IMMUNOLOGY HIV Antibodies/ANALYSIS HIV Antigens/*ANALYSIS HIV Infections/*DIAGNOSIS HIV Seropositivity/DIAGNOSIS Immunoenzyme Techniques Infant, Newborn Pregnancy Pregnancy Complications, Infectious/DIAGNOSIS Risk Factors T-Lymphocytes/IMMUNOLOGY 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.
