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Human Immunodeficiency Virus

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  • Authors: Wendy S. Armstrong1, Jeannette Guarner2, Colleen S. Kraft3, Angela M. Caliendo4
  • Editors: Randall T. Hayden5, Donna M. Wolk6, Karen C. Carroll7, Yi-Wei Tang8
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Division of Infectious Diseases, Emory University, Atlanta, GA 30322; 2: Division of Infectious Diseases, Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA 30322; 3: Division of Infectious Diseases, Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA 30322; 4: Department of Medicine, Alpert Medical School Brown University, Providence, RI 02903; 5: St. Jude’s Children’s Research Hospital, Memphis, TN; 6: Geisinger Clinic, Danville, PA; 7: Johns Hopkins University Hospital, Baltimore, MD; 8: Memorial Sloane-Kettering Institute, New York, NY
    • Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0024-2015
  • Received 05 October 2015 Accepted 01 February 2016 Published 01 July 2016
  • Angela Caliendo, [email protected]
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  • Abstract:

    In this chapter we will discuss the diagnosis and monitoring of individuals with HIV infection. The application and interpretation of these tests does not change dramatically when used in the immunocompromised host. The principal approach to the diagnosis of HIV infection involves serologic testing, although nucleic acid amplification tests play an important role in the diagnosis of acute HIV infection. The algorithm for diagnosis of HIV continues to evolve with newer assays that are able to detect infection within an earlier timeframe after HIV transmission. Viral load testing for HIV-1 is the cornerstone for monitoring patients on antiretroviral therapy. Genotypic and phenotypic resistance tests are employed when antiretroviral resistance is suspected and results help guide therapy. The tropism assay must be performed to determine the efficacy of CCR5 chemokine receptor antagonists. Next-generation sequencing methods are an innovative approach to assessing archived antiretroviral resistance in patients with virologic suppression. The success of antiretroviral therapy with improved long-term outcomes has made transplantation in HIV-infected patients a reality.

  • Citation: Armstrong W, Guarner J, Kraft C, Caliendo A. 2016. Human Immunodeficiency Virus. Microbiol Spectrum 4(4):DMIH2-0024-2015. doi:10.1128/microbiolspec.DMIH2-0024-2015.

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2016-07-01
2019-11-13

Abstract:

In this chapter we will discuss the diagnosis and monitoring of individuals with HIV infection. The application and interpretation of these tests does not change dramatically when used in the immunocompromised host. The principal approach to the diagnosis of HIV infection involves serologic testing, although nucleic acid amplification tests play an important role in the diagnosis of acute HIV infection. The algorithm for diagnosis of HIV continues to evolve with newer assays that are able to detect infection within an earlier timeframe after HIV transmission. Viral load testing for HIV-1 is the cornerstone for monitoring patients on antiretroviral therapy. Genotypic and phenotypic resistance tests are employed when antiretroviral resistance is suspected and results help guide therapy. The tropism assay must be performed to determine the efficacy of CCR5 chemokine receptor antagonists. Next-generation sequencing methods are an innovative approach to assessing archived antiretroviral resistance in patients with virologic suppression. The success of antiretroviral therapy with improved long-term outcomes has made transplantation in HIV-infected patients a reality.

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Human Immunodeficiency Virus
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Citation: Armstrong W, Guarner J, Kraft C, Caliendo A. 2016. Human immunodeficiency virus. microbiolspec 4(4): doi:10.1128/microbiolspec.DMIH2-0024-2015
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0024-2015.fig1
FIGURE 1

Life cycle of HIV-1. Reprinted from reference 59 , with permission.

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Image of FIGURE 1

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FIGURE 1

Life cycle of HIV-1. Reprinted from reference 59 , with permission.

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0024-2015
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FIGURE 2

Timeline for detection of virus using different assays, as compared to Western blot.

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FIGURE 2

Timeline for detection of virus using different assays, as compared to Western blot.

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FIGURE 3

CDC and Association of Public Health Laboratories guideline for diagnosis of HIV infection.

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FIGURE 3

CDC and Association of Public Health Laboratories guideline for diagnosis of HIV infection.

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Tables

Human Immunodeficiency Virus
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Citation: Armstrong W, Guarner J, Kraft C, Caliendo A. 2016. Human immunodeficiency virus. microbiolspec 4(4): doi:10.1128/microbiolspec.DMIH2-0024-2015
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0024-2015.T1
TABLE 1

Examples of HIV-1 serologic assays

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TABLE 1

Examples of HIV-1 serologic assays

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0024-2015
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0024-2015.T2
TABLE 2

Second-generation rapid HIV tests and second-generation rapid differentiation tests

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TABLE 2

Second-generation rapid HIV tests and second-generation rapid differentiation tests

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0024-2015
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0024-2015.T3
TABLE 3

FDA-approved real-time PCR tests for quantification of HIV-1 RNA

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TABLE 3

FDA-approved real-time PCR tests for quantification of HIV-1 RNA

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0024-2015
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0024-2015.T4
TABLE 4

Selected assays for resistance testing

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TABLE 4

Selected assays for resistance testing

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0024-2015

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