Early and complete detection of HIV exposure

Currently, HIV diagnosis relies on serology. Yet in groups at high risk for HIV serology is not sufficient because of the window period between infection and seroconversion. There is a growing body of reports on HIV-infected yet seronegative individuals. Some tests have been developed to identify exposure to HIV by its effect on the cells of the immune system that would differentiate following exposure to the foreign antigens. Detection, in vitro, of HIV-specific B and T cells in seronegative, at risk individuals has been reported. In only some of these individuals was an HIV infection confirmed by other methods. These new assays to detect HIV immunity enable us to identify two new groups among seronegative, at risk individuals; namely those with immunity to HIV and a detectable HIV infection (silent carriers), and those with immunity and no proof of infection. Both groups have been exposed to HIV yet are not being detected by serology. Both might hold information on other forms of HIV immunity, possibly a protective one. Thus there could be an important role for other immunological assays in early detection of HIV exposure.