Human Immunodeficiency Viruses

Abstract

The human immunodeficiency virus (HIV) is the etiologic agent of AIDS. HIVs are enveloped plus-stranded RNA viruses. The HIV genome is organized similarly to other retroviruses. It contains the gag, pol, and env genes which encode structural proteins, viral enzymes, and envelope glycoproteins, respectively. The major structural proteins which are encoded by the gag gene include p17, p24, p7, and p9. Replication begins with the attachment of virus to the target cell via the interaction of gp120 and the cellular receptor CD4. Both HIV-1 and HIV-2 have the same modes of transmission. The most common mode of HIV infection is sexual transmission at the genital mucosa through direct contact with infected blood fluids, including blood, semen, and vaginal secretions. Serological testing for HIV antibody is used for various purposes, including primary diagnosis, screening of blood products, management of untested persons in labor and delivery, evaluation of occupational exposures to blood/body fluid, and epidemiological surveillance. The first generation of HIV antibody assays relied on the detection of antibody to HIV viral protein lysates. A test using a sandwich-capture format and significantly more blood than other methods was more sensitive in early seroconversion. HIV-1 RNA load testing is sometimes requested to resolve equivocal serologic findings or to facilitate the diagnosis of HIV-1 infection during the acute phase or in a pediatric setting.