Virologic diagnosis of HIV infection in children]

The rate of mother-to-infant transmission of the HIV approximates 20%. Early treatment and monitoring of infected infants are feasible only if diagnosis is established promptly. Diagnosis at birth relies on techniques that demonstrate presence of the virus (viral cultures, Polymerase Chain Reaction (PCR) antigenemia). However, beyond six months of age, detection of evidence of an immune response to the virus can also be used (anti-HIV IgA, in vitro production of antibodies: ELISPOT or in vitro antibody production (IVAP). In practice, it should be borne in mind that the sensitivity of each technique varies with age.     

Persistent viruses in serological diagnosis of HIV infection]

Specific antibodies to persistent viruses (CMV, EBV, HBV) were detected by ELISA in groups of HIV-infected patients and persons showing indefinite results of the immunoblotting test for HIV-1 antigens, on the one hand, and in HIV-seronegative donors and patients with clinical manifestations of viral infection (CMVI) on the other. The findings indicate that the persons with indefinite immunoblotting test results show elevated blood CMV and HBV antigen levels than in the matched group of seronegative donors. This fact suggests that persistent viral infections might involve in the formation of an indefinite pattern when the sera were tested for HIV. The patients whose sera behaved in such a way represent a clinical risk group for HIV infection and call for further follow-up.     

Laboratory diagnosis of HIV infection

The diagnosis of HIV infection is generally lead using two different ELISAs to detect specific anti-HIV antibodies, the eventual reactivity must then be confirmed by a Western Blot The antibodies can be detected only 1-6 months after the infection; in fact in the earliest phases neither the antibodies, for their low titre, nor the specific antigens, for the antibodies could form immune complexes, can be detected by the achieved methods. Only the viral isolation can reveal the presence of the virus in this early phase, but the isolation must be conducted only in adequately safe laboratories (P3 laboratories). The only test able to replace the viral isolation is the Polymerase Chain Reaction (PCR). The PCR technique can be useful to reveal an HIV infection in its early phase and to monitor the infection progression and the efficacy of an antiretroviral treatment     

Brain cryptococcosis in HIV infection]

A 30-year-old female with HIV-infection (AIDS-stage) died with generalized, including meningoencephalitis, infection. Fungi found in the brain were identified as Cryptococcus neoformans. Fungal cells were also found in the lungs and in the necrotic phlegmon of soft tissue i. e. there was a generalized Cryptococcus infection.     

Serologic characterization of human immunodeficiency virus infection by Western blot and radioimmunoprecipitation assays

The Western blot and radioimmunoprecipitation assay (RIPA) appear to be the most specific tests available for the detection of antibodies directed against human immunodeficiency virus (HIV). An investigation of 678 HIV-seropositive samples from 518 patients by the Western blot assay indicates that the majority of patients who have been exposed to HIV exhibit antibodies directed against glycoprotein (gp) 41. The HIV-seropositive samples were categorized into four groups according to their Western blot antibody reactive patterns. Group 1 had evidence of reactivities directed against protein (p) 24 and gp41; group 2 had reactivity to gp41 and no reactivity to p24; group 3 had reactivity to p24 and p55 and no reactivity to gp41; and group 4 had an isolated p24 reactivity. The RIPA revealed antibody reactivities directed against HIV envelope proteins (gp 160, gp 120, and gp41) in 91 of 95 samples that were tested. No HIV antibody reactivities were detected by RIPA in four samples from group 4. Specimens exhibiting an isolated antibody reactivity directed against p24 by Western blot analysis should have further evaluation before being labeled as indicative of HIV exposure. A western blot study on a subsequent sequential sample or another confirmatory assay, such as the RIPA, should be performed to identify antibodies directed against HIV envelope components.     

Pneumocystis carinii infection in a HIV infection department]

To determine the prevalence of Pneumocystis carinii in the HIV-infection department, a simultaneous survey was made of 33 HIV-infected patients at various stages of the disease, of close relatives that were nursing the patients in the unit (n-7), and of medical staff of the department (n-20). Patients with toxic infections who were on another floor of the same hospital and medical students were examined as a control group. For detection of P. carinii antigen, smears from the deep airways were tested in the immunofluorescence. P. carinii was detected in 87.7% of HIV-infected patients, in 71.4% of their relatives and in 80.0% of the medical staff, in 16.6% of control patients and 27.7% of students. The main type of the infectious process in pneumocystosis is its carriage; 2 patients at a stage of relapses (IIIB) that corresponds to AIDS were recorded as having pneumocystis pneumonia.     

A sensitive radioimmunoprecipitation assay for human immunodeficiency virus (HIV)

A sensitive and efficient radioimmunoprecipitation procedure is described which provides an alternative to Western blotting assays for characterizing antibodies directed against human immunodeficiency viruses (HIV-1). Reaction of solubilized preparations of HTLV-III with 125I-labeled Bolton-Hunter reagent leads to the efficient labeling of all of the major virus-specific proteins, including gp120, gp41, RT (p66/p51), p24, and p17. These labeled proteins are readily immunoprecipitated by immune human sera, by specific sera derived from hyperimmunized animals, and by monoclonal antibodies. This procedure, referred to as BH-RIP, provides a simple assay for characterizing and titering antibodies against HIV which is equivalent in specificity, and more sensitive and efficient than the Western blotting method. In addition, viral proteins labeled in this way are suitable for biochemical studies. In one such application, the number of high-mannose and complex oligosaccharide side chains of gp120 and gp41 were determined by examining the sensitivities of the two viral glycoproteins labeled by this procedure to the glycosidases Endo H and PNGase F.     

The factors that affect the results of the serological diagnosis of HIV infection and the screening for anti-HIV]

The laboratory diagnosis of HIV infection and screening for anti-HIV have determined the factors that influence the results of studies performed by ELISA and Western immunoblot. The factors include sensitivity and specificity of the test systems used, storage conditions of and transportation conditions for serum, errors of procedures for reactions, etc. Correlation is between the inactivation of the sera studied and the initial antibody titers during their storage at elevated temperatures. To obtain more valid results of HIV infection serodiagnosis it is necessary to use some test systems differing in the principles of setting up a reaction.     

Serotypical profile of HIV infection in Moscow]

A total of 310 sera from HIV-1 infected patients detected in Moscow were serologically typed using 10 V3-imitating synthetic peptides. Subtype B virus is the most prevalent in Moscow (66.7%), serotype A/C ranks second (21.3%).     

HIV infections. Problems of morphologic diagnosis]

Considerable ultrastructural changes in the lymphoid cells of immunocompetent organs as well as in the epithelial and stromal cells of the rectum--the organ of the first contact with the virus in some cases--are found in HIV-infection. These alterations are of a quantitative nature and are the indications of important disturbances of the water-salt and protein metabolism. Changes in the lymphocytes and plasmacytes of the rectum lamina propria result in the damage to local immune defense. The presence of tubuloreticular and tubulo-annular structures in various cells of the rectum and lymphoid organs which are clearly seen in the biopsy material is most likely a characteristic sign of HIV-infection at its terminal stage.     

Hemostatic disorders in patients with HIV infection]

Impaired hemostasis was studied in 50 adult patients with HIV infection. The blood coagulative potential, the number and functional activity of platelets were examined. Platelet aggregation and secretion were shown to change earlier than thrombocytopenia developed and clinical signs of HIV infection appeared. The disturbance in the plasma section of hemostasis are due to concurrent opportunistic diseases and infections.     

双重荧光PCR检测HIV前病毒DNA及其在婴幼儿HIV感染早期诊断中的应用

目的建立双重荧光PCR检测HIV前病毒DNA的方法,并应用于婴幼儿HIV感染的早期诊断。方法采用TaqMan技术,组建针对人类核糖核酸酶P（ RNase P）和HIV的长末端重复序列（ LTR）基因的双重荧光PCR体系;采用TA克隆技术构建pTG19-T重组质粒作为模板进行该方法灵敏度的评价;采用11例已知健康人的血样和98例已知HIV感染者血样进行该方法的特异性验证;收集2011年1月至2012年9月浙江省各地妇幼保健医疗机构上送的96份婴幼儿样本,用新方法进行HIV的早期诊断,并将检测结果与罗氏HIV DNA定性检测试剂盒作比较。结果双重荧光PCR新方法能特异性检测HIV前病毒DNA,特异性为100％,检测灵敏度为100拷贝/反应;新方法和罗氏HIV DNA定性检测试剂盒检测96份婴幼儿样本,结果完全一致（符合率为100％）。结论建立的双重荧光PCR方法经济便捷、特异性好、灵敏度高、结果准确、易于推广,有望用于婴幼儿HIV早期诊断,并为HIV前病毒DNA的检测提供了一个通用技术平台。     

Cryptosporidium species in persons with HIV infection]

Oocysts of Cryptosporidium sp. were detected in the faeces of 65 subjects with the HIV virus, using the concentrating flotation method in a sugar solution and differential staining with methyl violet. In positive cases (a total of 16 subjects) continuous as well as intermittent excretion of oocysts in faeces was recorded, the longest excretion period being up to 15 months. The presented findings of oocysts confirm that Cryptosporidium sp. is a common intestinal pathogenic organism in the investigated group of subjects, and with regard to its pathogenity and opportunistic character they must be subjected to regular parasitological examinations.