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Chapter 72 : Principles and Procedures of Human Immunodeficiency Virus Diagnosis

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Abstract:

The human immunodeficiency virus (HIV) is the etiologic agent of AIDS. The clinical manifestations of AIDS were first recognized in 1981 (1). Search for the cause of this severe cellular immune dysfunction led to isolation of lymphadenopathy-associated virus in 1983 (2). The following year, additional researchers isolated cytopathic retroviruses from persons with AIDS, which they termed human T-lymphotrophic virus type III (3, 4). These viruses were soon confirmed to be identical, and in 1986 the International Committee on Taxonomy of Viruses named the virus causative of AIDS HIV (5). Genetic sequences of HIV have been identified retrospectively in human plasma specimens from as early as 1959 (6). It is estimated that approximately 75 million people worldwide have become infected with HIV. In the United States, the Centers for Disease Control and Prevention (CDC) estimates that 1.1 million persons are living with HIV.

Citation: Curtis K, Johnson J, Owen S. 2016. Principles and Procedures of Human Immunodeficiency Virus Diagnosis, p 696-710. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch72
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Figures

Image of FIGURE 1
FIGURE 1

Structure of the HIV virion. The HIV genome consists of three major genes that encode the viral enzymatic and structural proteins: group-specific antigens or capsid proteins (Gag), polymerase, protease, and integrase enzymes (Pol), and envelope glycoproteins (Env). The nomenclature of viral proteins indicates either “gp” for glycoprotein or “p” for protein, followed by a number indicating its molecular weight in thousands. The major components of diagnostic utility for HIV-1 include envelope proteins (gp160, gp120, gp41), the core gene proteins (p55, p24, p17), and polymerase gene proteins (p66, p51, p31). HIV-2 proteins are similar but differ somewhat in the molecular weights of the three gene products (refer to Table 1 ).

Citation: Curtis K, Johnson J, Owen S. 2016. Principles and Procedures of Human Immunodeficiency Virus Diagnosis, p 696-710. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch72
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Image of FIGURE 2
FIGURE 2

Time course of appearance of laboratory markers for HIV-1 infection. Units for vertical axis not given because the magnitude differs for RNA, p24 antigen, and antibody. Adapted data from reference and updated with data from references 10 .

Citation: Curtis K, Johnson J, Owen S. 2016. Principles and Procedures of Human Immunodeficiency Virus Diagnosis, p 696-710. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch72
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Image of FIGURE 3
FIGURE 3

CDC and APHL recommended laboratory diagnostic HIV testing algorithm showing sequence of follow-up testing. Ag, antigen.

Citation: Curtis K, Johnson J, Owen S. 2016. Principles and Procedures of Human Immunodeficiency Virus Diagnosis, p 696-710. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch72
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Tables

Generic image for table
TABLE 1

Major HIV proteins of diagnostic significance

Citation: Curtis K, Johnson J, Owen S. 2016. Principles and Procedures of Human Immunodeficiency Virus Diagnosis, p 696-710. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch72
Generic image for table
TABLE 2

FDA-approved conventional laboratory HIV immunoassays

Citation: Curtis K, Johnson J, Owen S. 2016. Principles and Procedures of Human Immunodeficiency Virus Diagnosis, p 696-710. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch72
Generic image for table
TABLE 3

FDA-approved rapid and POC HIV tests

Citation: Curtis K, Johnson J, Owen S. 2016. Principles and Procedures of Human Immunodeficiency Virus Diagnosis, p 696-710. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch72
Generic image for table
TABLE 4

Nucleic acid tests

Citation: Curtis K, Johnson J, Owen S. 2016. Principles and Procedures of Human Immunodeficiency Virus Diagnosis, p 696-710. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch72
Generic image for table
TABLE 5

Assays for drug resistance and cell tropism determination

Citation: Curtis K, Johnson J, Owen S. 2016. Principles and Procedures of Human Immunodeficiency Virus Diagnosis, p 696-710. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch72

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