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Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
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Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays

Published on: September 26, 2011

Human immunodeficiency virus type 1 detected in all seropositive symptomatic and asymptomatic individuals

J B Jackson1, S Y Kwok, J J Sninsky

  • 1Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis 55455.

Journal of Clinical Microbiology
|January 1, 1990
PubMed

Insights

This study confirms that human immunodeficiency virus type 1 (HIV-1) antibody positivity indicates current HIV-1 infection. Polymerase chain reaction (PCR) and culture methods effectively detect HIV-1 DNA and virus, outperforming serum antigen tests.

Area of Science:

  • Virology
  • Immunology
  • Infectious Diseases

Background:

  • Antibody testing for human immunodeficiency virus type 1 (HIV-1) is a primary screening method.
  • Direct methods to confirm active HIV-1 infection are crucial for diagnosis and management.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of HIV-1 culture and polymerase chain reaction (PCR) assays.
  • To compare these methods with serum HIV-1 antigen testing.
  • To confirm the association between HIV-1 antibody positivity and active viral presence.

Main Methods:

  • Peripheral mononuclear blood cells (PBMC) from 409 HIV-1 antibody-positive individuals and 131 HIV-1 antibody-negative controls were tested.
  • HIV-1 was detected using viral culture and PCR for HIV-1 DNA sequences.
  • A subset of hemophiliacs (59 HIV-1 positive, 20 negative) were also tested using both methods.

Main Results:

  • HIV-1 was successfully isolated or HIV-1 DNA detected in all 409 HIV-1 antibody-positive individuals.
  • No HIV-1 was detected in any of the HIV-1 antibody-negative individuals.
  • PCR and culture demonstrated high sensitivity (≥97%) and specificity (100%), outperforming serum antigen tests (sensitivity 42% in AIDS patients, 17% in asymptomatic).

Conclusions:

  • HIV-1 antibody positivity is definitively associated with current HIV-1 infection.
  • Both HIV-1 PCR and viral culture are highly sensitive and specific methods for detecting active HIV-1 infection.
  • PCR and culture are superior to serum antigen testing for direct HIV-1 detection.

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