Exposure to human immunodeficiency virus type 1-specific T helper cell responses before detection of infection by polymerase chain reaction and serum antibodies

Article Abstract:

Infection with the human immunodeficiency virus (HIV) should be treated early with antiviral agents to delay the progression of HIV infection and decrease the symptoms of disease. An AIDS vaccine is currently being tested in HIV-infected patients. However, HIV-infected patients can only be treated early if the infection is detected early. HIV infection can occur from several weeks to more than three years between exposure to the virus and the detection of HIV antibodies (immune proteins directed against the virus). Certain immune and genetic methods, including measurement of reverse transcriptase, polymerase chain reaction (PCR), and HIV antigen capture, have been effective in identifying HIV infection at an early stage, even before HIV antibodies can be detected. A case is described of a 40-year-old homosexual man who did not have HIV antibodies and was in good general health. Although he admitted to being promiscuous in the past, the patient had been involved in a monogamous relationship for eight months. He did not have a history of blood transfusion, intravenous drug use, or sexually transmitted disease. The patient was tested for HIV infection by monitoring the function of the immune T helper (Th) cells, the presence of HIV DNA, and HIV antibodies at 1, 5, 13, 16, and 19 months. When peripheral blood mononuclear cells (PBMC) are exposed to viral antigens, or elements of the virus that trigger an immune reaction, PBMC proliferate or grow rapidly into immune T cells and release interleukin-2, a factor that increases the growth of T cells. The patient's PBMCs were exposed to proteins that were similar to HIV antigens and the ability of the PBMCs to release interleukin-2 and proliferate into T cells was assessed. In addition, the presence of HIV DNA in PBMCs was assessed using PCR, which amplifies or makes several copies of DNA in amounts that are sufficient for analysis. The presence of HIV antibodies and p24 antigen, an indicator of HIV infection, in the blood were also monitored. The Th tests were positive from 5 to 19 months, indicating exposure of PBMC to HIV, whereas PCR and blood tests were positive only at 19 months. Thus, Th tests are effective in detecting HIV antigens before HIV antibodies and HIV DNA can be measured. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Usage, Diagnosis, HIV infection, HIV infections, Polymerase chain reaction, T cells, HIV antigens, HIV antibodies

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Total lymphocyte count as a predictor of absolute CD4+ count and CD4+ percentage in HIV-infected persons

Article Abstract:

Measurement of total lymphocyte count (TLC) may be a reliable predictor of reduced blood levels of CD4+ T-cells, or cells of the immune system, in HIV-infected individuals. Total CD4+ T-cell count or CD4+ T-cell percentage has been used to monitor the development of immunosuppression in HIV-infected individuals. TLC and CD4+ T-cell levels were measured in 828 HIV-infected patients with no history of treatment with AZT. Ninety-five percent of the individuals with CD4+ T-cell levels less than 200 per cubic millimeter (/mm3) were identified by a TLC of less than 2,000/mm3. HIV-infected individuals with CD4+ T-cell levels below 200/mm3 are more likely to develop different types of opportunistic infections than those with higher blood levels. A measurement of TLC is simpler to perform than a CD4+ T-cell count. Some medical laboratories may not be equipped to perform CD4+ T-cell counts.

HIV patients, Lymphocytes, CD4 lymphocytes

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