The interferons (IFNs) belong to the body's natural defensive response mechanisms directed against virus infections including also the human immunodeficiency virus (HIV) infection. This review discusses the current knowledge concerning the role of IFNs types I and II during the HIV infection. The author analyzes the HIV-driven process of endogenous IFNs induction in different cell types as well as the development of unusual acid-labile IFN following the HIV infection, its nature and clinical significance. Possible action mechanisms of different exogenous IFN types against the HIV-infection are reviewed taking into consideration the stages of HIV replication accompanied by these mechanisms of action and describing both positive and negative roles of IFNs during this disease. The author discusses also some well-known IFN-inducible antiviral pathways participating in the anti-HIV mechanisms and enzymes realizing antiviral action (PKR, 2'5'-OAS, iNOS, IDO, Mx and 9-27 proteins). A problem of HIV defense against the anti-HIV IFN action as well as some aspects of HIV-accelerating IFN effects are also examined in detail.
To assess the effect of baseline HIV reverse transcriptase (RT) and protease sequence variation on virologic outcomes in a large cohort of antiretroviral-naive patients in British Columbia, Canada.
Population sequencing of RT and protease was performed on baseline viral RNA of all antiretroviral-naive patients first seeking treatment in British Columbia between June 1997 and August 1998 (n = 479). Relative risks of virological failure associated with genotypic differences from a 'standard' HIV strain (HXB2) were assessed for up to 18 months.
The prevalence of key baseline mutations known to confer resistance to RT and protease inhibitors (PI) was 3.4 and 3.8%, respectively. No statistically significant impact on virologic outcomes could be established for these patients. However, the data suggest that some individuals (harboring a M184V mutation in RT or a V82I in protease) may have benefited from pre-therapy resistance tests. 'Secondary' mutations in the protease associated with resistance (e.g. codons 10, 36 or 63) were common, but the presence of these secondary mutations, either alone or in combination, did not appear to result in early loss of therapeutic virological suppression. Preliminary analyses suggest that an amino acid change at codon 35 in the protease may be associated with early treatment failure.
The results suggest that routine genotyping of naive patients about to start antiretroviral therapy would be of benefit to a relatively small proportion of the population. Secondary mutations associated with resistance to PI alone were not found to affect virologic outcomes significantly.
The Genie HIV-1/2 kit (Sanofi Diagnostics Pasteur, Montreal, Quebec), a synthetic-peptide solid-phase enzyme immunoassay, was evaluated as a confirmatory assay for HIV-1 antibodies in comparison with Western blot (BioRad, Hercules, CA, USA) on 50 stored HIV-1 antibody-positive sera and the 137 sera yielding repeated positive results in the conventional EIA screen out of 13405 fresh patient sera from Saskatchewan in 1993. The stored HIV-1-positive sera were uniformly positive in the Genie test. Of the 137 EIA screen-positive sera, 33 were uniformly positive and 64 were uniformly negative in Genie and Western blot; 36 were Genie-negative and indeterminate by Western blot; and four were Genie indeterminate, of which one was negative and three were indeterminate by Western blot. All HIV-1 Western blot-indeterminate and Genie-interdeterminate sera were negative in radio-immunoprecipitation assay (RIPA) and Western blot for HIV-1 and HIV-2 antibodies performed by a reference laboratory. Genie gave an accurate definitive result for 97% of EIA positive sera compared with 71% for Western blot. There was excellent correlation between Genie, Western blot and RIPA results. However, the Genie assay was faster, less costly and yielded fewer indeterminate results than Western blot in confirmatory testing for HIV-1 antibodies.
The paper presents results of screening tests involving different groups of the population in the Ukraine, for antibodies to HIV, findings from epidemiologic investigation into cases with HIV-infection, with a view to outlining epidemiologic situation and assessing effectiveness of antiepidemic measures. HIV-transmission through sexual contacts is the commonest way of HIV-transportation in the Ukraine (66.1% of all cases of infection). An attempt is made of giving a short-term prognosis of epidemic situation in the Ukraine over a period of up to 1995. A conclusion is reached on the necessity of strengthening preventive measures with the view of influencing the unsafe forms of sexual behaviour.
The sensitivity and specificity of the developed anti-HIV1/2 third generation enzyme immunoassay, the IEA-HIV1/2-III, was examined. The test system for the detection of anti-HIV antibodies included peroxidase-conjugated HIV-specific recombinant Gag protein fragments (epitopes of p24 and p17 proteins), Env-1 (epitopes of p41 and p120 proteins), and Env-2 (p36 epitopes). Sensitivity was evaluated with 346 sera from HIV1-seropositive subjects, Anti-HIV1 Low Titer panels no. 10 and PRB-106 and seropositive panel PRB-931 in comparison with other third- and second-generation assays. The IEA-HIV1/2-III assays are characterized with high sensitivity comparable to the other third generation assays and the better sensitivity with respect to the second generation test-kit to determine HIV-specific antibodies in human sera. The specificity was determined using three hundred sixty-seven potentially cross-reactive samples (but negative for anti-HIV1/2). Only one specimen among them was reactive by IEA-HIV1/2-III.
In 2014 the Public Health Agency of Sweden and the Swedish Reference Group for Antiviral Therapy (RAV) conducted a review and analysis of the state of knowledge on the duration of follow-up after exposure to human immunodeficiency virus (HIV). Up until then a follow-up of 12 weeks after exposure had been recommended, but improved tests and new information on early diagnosis motivated a re-evaluation of the national recommendations by experts representing infectious diseases and microbiology, county medical officers, the RAV, the Public Health Agency, and other national authorities. Based on the current state of knowledge the Public Health Agency of Sweden and the RAV recommend, starting in April 2015, a follow-up period of 6 weeks after possible HIV-1 exposure, if HIV testing is performed using laboratory-based combination tests detecting both HIV antibody and antigen. If point-of-care rapid HIV tests are used, a follow-up period of 8 weeks is recommended, because currently available rapid tests have insufficient sensitivity for detection of HIV-1 antigen. A follow-up period of 12 weeks is recommended after a possible exposure for HIV-2, since presently used assays do not include HIV-2 antigens and only limited information is available on the development of HIV antibodies during early HIV-2 infection. If pre- or post-exposure prophylaxis is administered, the follow-up period is recommended to begin after completion of prophylaxis. Even if infection cannot be reliably excluded before the end of the recommended follow-up period, HIV testing should be performed at first contact for persons who seek such testing.