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 Detecting Recent Human
Immunodeficiency Virus Type 1 infection
Members
• Ayn Marie Lao
• Michelle Jay Francisco
• Jade Dianne Ong
• Eduard Frank Delos Reyes
• Jeffrey Cayetuna
• Kalvin Estanero
• Shahradee Azza Harain
• Vede Sullano
• Julius Caesar Tan
• Edgar Gerodias
• Zhenilane Tambut
• Katz dela Cruz
Review
HUMAN IMMUNODEFICIENCY VIRUS
• Retrovirus
• Lead to acquired
immunodeficiency syndrome
PREVIOUS NAMES

• Lymphadenopathy- associated virus

(LAV)
• Human T Lymphocyte Virus Type III
(HTLV III)
• Human Immunodeficiency Virus
(HIV)
• AIDS –Associated Virus (ARV)
TWO SPECIES
• HIV- TYPE I
- more virulent
- easily transmitted
- cause of majority of
- infections globally
• HIV- TYPE II
- less transmittable
- largely confined to West Africa
THREE MAJOR ROUTES

• Unprotected sexual intercourse

• Blood or blood products
• Mother- to- child transmission
Mechanism of entry to the cell
MORPHOLOGY OF VIRUS
Morphology of HIV
• Viral diameter 120 nm
• Roughly spherical
• 2 copies of positive single
stranded RNA
• Viral envelope composed of 2 layers
of phospholipid
• Envelope consists of cap made up 3
molecules called glycoprotein 120
• Stem composed of three glycoprotein
41
HIV- I RNA OR p24 antigen test

P24 antigen
• Sandwich ELISA
DETECTING RECENT HUMAN
IMMUNODEFICIENCY VIRUS
TYPE I INFECTION
• Seroconversion
– antibody
production
following
exposure to an
antigen
• Current serologic
window period
– 3 to 4 weeks
– HIV infection
cannot be
demonstrated
using antibody
tests
• p24 antigen test
– about 1 week
ELISA plate
Less sensitive enzyme
immunoassays
• Less-sensitive (LS) HIV enzyme
immunoassays (EIAs) can
distinguish persons who have
recent HIV infections from those
who have long-standing HIV
infection.
• Used to test prevalent HIV-
positive people and to detect
recent seroconversion (within
130 days).
• In most cases the EIA (enzyme
immunoassay), used on blood drawn
from a vein, is the most common
screening test used to look for
antibodies to HIV. A positive
(reactive) EIA must be used with
a follow-up (confirmatory) test
such as the Western blot to make
a positive diagnosis. There are
EIA tests that use other body
fluids to look for antibodies to
HIV. These include:
• Oral Fluid Tests – use oral
fluid (not saliva) that is
collected from the mouth
using a special collection
device. This is an EIA
antibody test similar to the
standard blood EIA test. A
follow-up confirmatory
Western blot uses the same
oral fluid sample.
• Urine Tests – use urine
instead of blood. The
sensitivity and specificity
(accuracy) are somewhat less
than that of the blood and
oral fluid tests. This is
also an EIA antibody test
similar to blood EIA tests
and requires a follow-up
confirmatory Western blot
using the same urine sample.
• When used as a second step in
an algorithm to test known
positives, it can help
identify recent infections,
the approach known as
serologic testing algorithm
for recent HIV seroconversion
or STARHS.
• This method measures antibody
levels quantitatively; hence
their performance in
divergent subtypes depends on
the extent of cross-
reactivity.
Maturation of Humoral
Response
• Antigen or epitope specific
response
• Antibody Titer
• Antibody Affinity
• Proportion of HIV-IgG
• Antibody Isotypes
IgG- capture EIA
• Uses microwells coated with
goat antihuman IgG which
captures both HIV and non-HIV
– IgG from the serum.
• Increasing levels of HIV-
specific antibodies can be
detected by this assay from
up to two years following
seroconversion.
 Incidence calculation
• From test results of cross
sectional cohort translated
to rate of new infections
occuring per year taking into
account the numbers of
individuals at risk.
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