Detection of human immunodeficiency virus DNA using the polymerase chain reaction in a well-characterized group of homosexual and bisexual men

Article Abstract:

A viral infection can be diagnosed by measuring viral antigens (the whole virus or viral components) or by measuring the antibodies that are produced by the body naturally in an effort to fight off the virus. Most diagnostic tests used to measure human immunodeficiency virus infections measure HIV antibodies. Although most people who are exposed to the virus develop HIV-antibodies within a few months, some people may take up to six months to develop an antibody response. Two methods of detecting the viral components include culturing the virus, which may not be successful, or assay tests, which are relatively insensitive. The polymerase chain reaction (PCR) is a process that can be used to detect the genetic material (DNA) from HIV-1. These samples are put through a cyclical process that amplifies the DNA by doubling it after every cycle. In some cases, patients who were negative for HIV-antibodies were positive after PCR tests. This would mean that a proportion of HIV-infected individuals go undetected when conventional antibody tests are used. The results obtained from antibody tests and PCR (after 30 cycles of amplification) were compared in homosexual and bisexual men participating in an AIDS study. Of the 197 men, 107 were negative and 90 were positive for the HIV antibody. Of the HIV-antibody-negative men, 105 were PCR-negative. However, in the two PCR-positive samples, retesting of the same blood samples and new samples removed 8-10 months later showed that both were PCR-negative. This means that the two PCR tests that were initially positive were false. In the group of HIV-antibody-positive men, 87 (97 percent) were positive by PCR methods. When the PCR-negative samples were retested, they all tested positive. It is possible that the two false-positive samples were contaminated with HIV-positive blood which was then amplified during PCR preparation techniques. Although there was a high agreement rate between the two testing methods, the value of PCR as a screening test for populations with a low prevalence of HIV-1 infection is not clear. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Measurement, HIV (Viruses), HIV, Identification and classification, Polymerase chain reaction, HIV antibodies

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Relationship between AIDS latency period and AIDS survival time in homosexual and bisexual men

Article Abstract:

The "latency period" in the progression of AIDS is the time from when individuals who are infected with the human immunodeficiency virus (HIV) develop antibodies to the virus in their blood (become seropositive) to when they first develop symptoms of AIDS. The relationship between the latency period and the survival time (survival time is the time elapsed from the first diagnosis of AIDS to death) was examined in homosexual and bisexual men from the San Francisco City Clinic Cohort. A study such as this allows the assessment of the progression of disease, and gives insight into how the disease develops. No significant correlation could be found between the latency period and survival time in the 277 homosexual and bisexual men studied. But a relationship was seen between the initial clinical symptom which allowed the diagnosis of AIDS and the latency period. Those who were first diagnosed with Kaposi's sarcoma (KS) had a shorter latency period but survived longer than those who were initially diagnosed with AIDS based on Pneumocystis carinii pneumonia or another AIDS diagnosis. Patients with KS are usually diagnosed earlier in the disease. The study showed that the survival time was not associated with: the estimated year of seroconversion; the year of first AIDS diagnosis; patient age at seroconversion; or racial/ethnic group. The findings suggest that, during HIV infection, there is continual weakening of the immune system. The use of antiviral and prophylactic therapies both before and after the diagnosis of AIDS may change the latency and survival times of those infected with HIV. (Consumer Summary produced by Reliance Medical Information, Inc.)

Development and progression, Prognosis, HIV infection, HIV infections

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