PubMed · 1458605
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D E Bruns. 1992. AIDS testing expands.. https://pubmed.ncbi.nlm.nih.gov/1458605/
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Early detection of human immunodeficiency virus (HIV) in blood and blood products can be achieved by a sensitive nucleic acid amplification-based assay. We report on the performance of a PCR-based qualitative assay that detects both HIV type 1 (HIV-1) and HIV-2 with a sensitivity of 20 to 50 copies/ml. The assay has a specificity of 99.6% and an inhibition rate of 1.7%. One milliliter of sample is processed with a manifold system and Qiagen columns, and one-third of the extracted sample is used for PCR amplification. An internal control sequence, which is processed and amplified with each sample, monitors for amplification inhibition. Samples are reverse transcribed and are then amplified by reverse transcription-coupled PCR, after which HIV-1- and HIV-2-specific probes are hybridized to the amplified products. Following hybridization, samples are detected in the LCx instrument by microparticle enzyme immunoassay techniques. The detection system has an automated inactivation step that controls for PCR contamination. The HIV-1/2 qualitative RNA assay detects HIV-1 group M subtypes A, B, C, D, E, F, and G and group O. Testing of several HIV-1 seroconversion panels has demonstrated that the HIV-1/2 qualitative RNA assay detects HIV infection on the average of 6 days before p24 antigen can be detected and 11 days before antibodies can be detected.
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Neutralization-escape variants of human immunodeficiency virus type 1 (HIV-1) were sought in persons who had persistent low virus loads and who remained asymptomatic for at least 12-16 years of infection without antiretroviral therapy. Viruses were isolated from 3 persons at two or three time points during the course of infection and were assessed for neutralization by sequential autologous serum samples. Virus neutralization was poor or undetectable with contemporaneous autologous serum but improved with later serum samples for each person. In particular, later isolates resisted neutralization by autologous serum samples that neutralized an earlier isolate. Strain-specific neutralizing antibodies remained detectable for up to 4.2 years without diminishing in titer. The results demonstrate that neutralization-escape variants arise periodically in HIV-1-infected long-term nonprogressors.