Comparison of antigen immunoassay and reverse transcriptase assay for monitoring human immunodeficiency virus infection in an antiviral trial

Stabilities of free and complexed human immunodeficiency virus p24 antigens during short- and long-term storage

By the standard p24 assay there was a 25 to 27% decrease in free p24 antigen in serum after storage at 4 degrees C over 14 days but no loss at -70 degrees C. There was no loss at either temperature by the immune complex dissociation (ICD) procedure. Furthermore, there was no significant loss of detectable p24 in serum by either the ICD or the standard p24 assay after 700 days of storage at -70 degrees C.

Comparable sensitivities for detection of HIV-1 reverse transcriptase (RT) and other polymerases by RT assays requiring no radioisotopic materials

An improved non-radioisotopic (Non-RI) reverse transcriptase (RT) assay with a template-primer-immobilized microtiter plate is described, which has greater sensitivity than the former Non-RI RT assay previously described. Non-RI and commercially available non-radioactive (Non-RA) RT assays were compared for their ability to detect various polymerases. Two RTs from Rous-associated virus 2 (RAV-2) and avian myeloblastosis virus (AMV), one polymerase from Escherichia coli (Pol-I) and one recombinant RT of human immunodeficiency virus type 1 (HIV-1) were assessed. Two HIV-1 samples in a culture supernatant and pelleted virion suspended in Triton X-100 solution were measured. The Non-RI RT assay was one hundred times more sensitive by RAV-2 and Pol-I polymerases, and one thousand times more sensitive by the Non-RA assay than by the AMV RT. The Non-RI RT assay was 10, 16 and 64 times more sensitive than the Non-RA assay for measuring recombinant HIV-1 RT, pelleted virus and virus suspended in culture medium, respectively. To explain the discrepancy, it is shown that free biotin, such as in culture medium, disturbs the assay system of the Non-RA RT assay, but not the Non-RI assay. The present assay can be used to clarify the inhibitory mechanism of an anti-HIV-1 substance.

Stimulatory effect of the CYP1A1 inducer 2,3,7,8-tetrachlorodibenzo-p-dioxin on the reproduction of HIV-1 in human lymphoid cell culture

1. 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) was an inducer of microsomal benzo[alpha]pyrene hydroxylase (AHH) and 7-ethoxyresorufin O-deethylase (EROD) in MT-4 human lymphoid cell culture. 2. The monoclonal antibody (Mab), 1-7-1 and the immunodepleted polyclonal antibody (Pab), anti-CYP1A1(-A2), inhibit AHH and EROD activities pre-induced by 10 nM TCDD in MT-4 cells. Hence, the specific monooxygenase isoform induced in the lymphoid cells by TCDD appears to be CYP1A1 the expression of which is mediated by the Ah receptor. 3. Incubation of MT-4 cells with TCDD at 10, 50 and 150 nM for 1.5 and 48 h followed by infection of the cells with human immunodeficiency virus 1 (HIV-1) was accompanied by a 3-6-fold increase in the activity of viral RNA-dependent DNA-polymerase. The most marked effect on reverse transcriptase activity occurred with 10 nM TCDD 5-9 days after HIV-1 infection. 4. In the same period there was accumulation of viral protein, determined by ELISA, with a 4-8-fold increase in production of viral protein. The above effects of TCDD have been observed even when MT-4 cells were washed 1.5 h after beginning the incubation with TCDD.

Prognostic value of kinetic parameters of HIV isolation from peripheral blood mononuclear cells

To assess the correlations between clinical and biological stages of HIV infection and HIV isolation, peripheral blood mononuclear cells from 389 HIV-infected patients were studied by 30-day cocultures with normal lymphocytes. HIV isolation was successful in 279/389 patients (71.7%). Positive isolation was more frequent in CDC IV cases (82%) than in CDC II and III cases (63.6% and 78.4% respectively). There was a close correlation between culture positivity and serum beta 2-microglobulin, CD4+ cell counts and serum p24 antigen. The day of peak detection of reverse transcriptase activity or peak p24 antigen in coculture supernatants was selected as a coculture kinetic parameter. The day of peak detection of HIV in culture occurred earlier in CDC IV cases than in CDC II and III cases, and was a prognostic factor in AIDS progression at 2 years. These data suggest that in vitro parameters related to both viral burden and replicative capacity of HIV isolates are relevant indicators of disease progression.

Quantitative analysis of human immunodeficiency virus type-1 DNA in asymptomatic carriers using the polymerase chain reaction

A method for detecting human immunodeficiency virus type 1 (HIV-1) provirus DNA in lymphocytes with improved sensitivity and reproducibility was developed using the polymerase chain reaction (PCR). Amplified HIV-1 DNA was hybridized with a 32P-labeled probe and quantitated with a beta-scanner after electrophoresis. A linear relationship was obtained between the common logarithms of the counts detected and the number of HIV-1 DNA copies applied to the PCR. Detectability was from 3 copies/10(5) lymphocytes, and linearity was maintained from 10 to 10(3) copies. HIV-1 DNA was detected in all 9 asymptomatic carriers tested (18 to 2,857 copies/10(5) CD4+ T lymphocytes). The viral burden was inversely related to the CD4+ lymphocyte count, suggesting that quantitation of provirus levels may serve as a predictor of progress in early HIV infection.

Comparison of different methods for detecting human immune deficiency virus in human immunodeficiency virus-seropositive hemophiliacs

Since the detection of antibodies against the human immune deficiency virus (HIV) does not definitely prove HIV infection in hemophiliacs, virus detection was attempted by virus isolation from the peripheral blood monocytes (PBL), by demonstration of p24 antigen and decline of p24 antibody, and by detection of viral DNA by the polymerase chain reaction (PCR). Virus isolation was optimized by immediate coculture of PBL and by replacement of the reverse transcriptase test by the p24 antigen test, whereas the elimination of CD8+ lymphocytes proved to be unnecessary. Virus detection was dependent on the clinical stage of the illness. Virus isolation in 70 of 211 patients (33%) was more sensitive than detection of p24 antigen or decline of p24 antibody. PCR was performed in 25 patients and indicated infection in all of 15 isolation-positive cases and in 6 of 10 patients from whom virus was not isolated. Changes from negative to positive virus culture and from a weakly fusiogenic to a highly fusiogenic isolate were often accompanied by a progression of the disease. The results suggest that reactivation of HIV occurs when immune deficiency has become manifest. Apparently virus isolation detects only the virus already reactivated in vivo, whereas the PCR may also detect latent virus.

The diagnosis of human immunodeficiency virus infection: progress in less than five years

Diagnostic tests for human immunodeficiency virus first became commercially available in 1985, only two years after the virus was discovered. In the short period of time since then, we have witnessed improvements in antibody detection methods, refinements in culture techniques, and the introduction of antigen and nucleic acid detection methods, including the polymerase chain reaction. These diagnostic tools as well as their advantages and disadvantages are reviewed in this report.