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Taxonomy Information
- Species:
- Human immunodeficiency virus (Website 1):
- Common Name: Human immunodeficiency virus
- GenBank Taxonomy No.: 12721
- Description: AIDS is an extraordinary kind of a crisis. AIDS is unique in human history in its rapid spread, its extent and the depth of its impact. Since the first AIDS case was diagnosed in 1981, the world has struggled to come to grips with its extraordinary dimensions. Early efforts to mount an effective response were fragmented, piecemeal and vastly underresourced. Few communities recognized the dangers ahead, and even fewer were able to mount an effective response. Now, more than 20 years later, 20 million people are dead and 37.8 million people (range: 34.6 - 42.3 million) worldwide are living with HIV. And still, AIDS expands relentlessly, destroying peoples lives and in many cases seriously damaging the fabric of societies(UNAIDS et al., 2004). AIDS was first recognized in the United States in 1981, following an increase in the incidence of usually rare opportunistic infections (such as the pneumonia caused by Pneumocystis carinii) in homosexual men that were caused by a general immune deficiency. Human immunodeficiency virus (HIV) was first isolated in 1983 and by the mid-1980s it was evident that two types of HIV, with slightly different genome structures, were circulating in human populations. Both viruses are characterized by extensive genetic diversity; HIV-1 is phylogenetically divided into three groups - M, N and O, with the M group further split into 9 subtypes and 15 circulating recombinant forms. Today, group M has a near global distribution, whereas groups N and O are restricted to individuals of West African origin. HIV-2 is also most common in individuals from West Africa and is composed of seven subtypes. Despite its initial association with homosexual men, it is clear that HIV-1 and HIV-2 are now primarily transmitted by heterosexual intercourse and from mother to infant(Rambaut et al., 2004). Several independent isolates, called lymphadenopathy-associated virus or LAV, human T-cell lymphotropic virus type III, or HTLV-III, and AIDS-associated retrovirus or ARV by the laboratories of origin, are similar with respect to morphology, cytopathology, requirements for optimum reverse transcriptase activity, at least some antigenic properties, and some restriction endonuclease cleavage sites in viral DNA. Epidemiological studies show that infection by one of these viruses may be a necessary condition for the development of AIDS, although predisposing factors may contribute to the onset of the disease. Certain taxonomic issues need to be addressed with respect to the relationships among the human retroviruses at the nucleotide level. A probe representative of ARV-2 anneals under high stringency conditions to restriction enzyme DNA fragments from cells infected with LAV or with HTLV-III. Thus, these three retroviruses are closely related(Sanchez-Pescador et al., 1985).
- Variant(s):
- Human immunodeficiency virus type 1 (Website 2):
- Common Name: Human immunodeficiency virus type 1
- GenBank Taxonomy No.: 11676
- Parents: Human immunodeficiency virus
- Description: HIV-1 is most closely related to simian immunodeficiency virus chimpanzee (SIVcpz), which is found in some sub-species of chimpanzee (Pan troglodytes troglodytes and Pan troglodytes schweinfurthii) that inhabit parts of equatorial Western and Central Africa, respectively. SIVcpz from P. t. troglodytes is of most interest because it shares the closest relationship with the abundant HIV-1 M group. The geographical range of P. t. troglodytes also encompasses the region in Africa that has the greatest genetic diversity of HIV-1, containing groups M, N and O; such a distribution is expected if this was where HIV-1 first emerged(Rambaut et al., 2004).
- Human immunodeficiency virus type 2 (Website 3):
- Common Name: Human immunodeficiency virus type 2
- GenBank Taxonomy No.: 11709
- Parents: Human immunodeficiency virus
- Description: HIV-2 is most closely related to SIVsm5, which is found at high prevalence in sooty mangabey monkeys (Cercocebus atys). As with HIV-1, sooty mangabeys are most frequent in the regions of West Africa where HIV-2 is likely to have emerged(Rambaut et al., 2004).
- Human immunodeficiency virus type 3 (Website 4):
- Common Name: Human immunodeficiency virus type 3
- GenBank Taxonomy No.: 35274
- Parents: Human immunodeficiency virus
- Description: Described is a new variety of retrovirus designated HIV-3, also known as HIV-1 subtype O, samples of which are deposited in the European Collection of Animal Cell Cultures (ECACC) under V88060301(US Patent Office Website).
- Human immunodeficiency virus type 1 (ARV2/SF2 ISOLATE) (Website 5):
- Common Name: Human immunodeficiency virus type 1 (ARV2/SF2 ISOLATE)
- GenBank Taxonomy No.: 11685
- Parents: Human immunodeficiency virus
- Description: The complete DNA sequence of ARV-2 reveals a fundamental genetic structure similar to that of other retroviruses. A distinct group of human retroviruses has been isolated from patients with the acquired immune deficiency syndrome (AIDS) and individuals with related conditions, such as persistent lymphadenopathy. Several independent isolates, called lymphadenopathy-associated virus or LAV, human T-cell lymphotropic virus type III, or HTLV-III, and AIDS-associated retrovirus or ARV by the laboratories of origin, are similar with respect to morphology, cytopathology, requirements for optimum reverse transcriptase activity, at least some antigenic properties, and some restriction endonuclease cleavage sites in viral DNA. Epidemiological studies show that infection by one of these viruses may be a necessary condition for the development of AIDS, although predisposing factors may contribute to the onset of the disease. Certain taxonomic issues need to be addressed with respect to the relationships among the human retroviruses at the nucleotide level. A probe representative of ARV-2 anneals under high stringency conditions to restriction enzyme DNA fragments from cells infected with LAV or with HTLV-III. Thus, these three retroviruses are closely related(Sanchez-Pescador et al., 1985). Approximately 17% divergence was observed between HXB-3 and ARV-2 sequences, which was most pronounced in the extracellular region of the envelope protein. The observed differences in sequence probably reflect divergent evolution of strains separated in time and geography. ARV-2 was recently isolated from the west coast of the United States. The HTLV-III isolates for which nucleotide sequences have been determined were all obtained from the east coast about one year earlier. Regardless of the reasons, the fact that such divergence can occur, and that it is more pronounced in the extracellular portion of the envelope protein, is an important consideration in the design of both diagnostic reagents and possible vaccines(Crowl et al., 1985).
- Human immunodeficiency virus type 1 (BH10 ISOLATE) (Website 6):
- Common Name: Human immunodeficiency virus type 1 (BH10 ISOLATE)
- GenBank Taxonomy No.: 11678
- Parents: Human immunodeficiency virus
- Description: Clones BH10, BH8 and BH5 were derived from a library of SstI-digested DNA from HTLV-III-infected H9 cells cloned in lambda -gtWes_ lambda-B(Ratner et al., 1985).
- Human immunodeficiency virus type 1 (BH5 ISOLATE) (Website 7):
- Common Name: Human immunodeficiency virus type 1 (BH5 ISOLATE)
- GenBank Taxonomy No.: 11682
- Parents: Human immunodeficiency virus
- Description: Clones BH10, BH8 and BH5 were derived from a library of SstI-digested DNA from HTLV-III-infected H9 cells cloned in lambda -gtWes_ lambda-B(Ratner et al., 1985).
- Human immunodeficiency virus type 1 (BH7 ISOLATE) (Website 8):
- Human immunodeficiency virus type 1 (BH8 ISOLATE) (Website 9):
- Common Name: Human immunodeficiency virus type 1 (BH8 ISOLATE)
- GenBank Taxonomy No.: 11684
- Parents: Human immunodeficiency virus
- Description: Clones BH10, BH8 and BH5 were derived from a library of SstI-digested DNA from HTLV-III-infected H9 cells cloned in lambda-gtWes_ lambda-B(Ratner et al., 1985).
- Human immunodeficiency virus type 1 (BRAIN ISOLATE) (Website 10):
- Common Name: Human immunodeficiency virus type 1 (BRAIN ISOLATE)
- GenBank Taxonomy No.: 11693
- Parents: Human immunodeficiency virus
- Description: HIV-1 BR (BRAIN) was isolated from autopsied brain tissue (frozen unfixed for 2 years) by cocultivating minced brain tissue (from frontal, occipital, and parietal lobes) with 3-day-old phytohemagglutin (PHA)-stimulated peripheral blood lymphocytes (PBLs). When compared for the rate of replication HIV-1 BR was up to 10-fold lower than HIV-1 451. In the extent of cytopathicity to CD4+ cells, HIV-1 BR was also lower than HIV-1 451. In addition, HIV-1 BR replicated in ROHA and U937 cell lines but to lesser extent than the prototype virus HIV-1 LAV.
- Human immunodeficiency virus type 1 (BRU ISOLATE) (Website 11):
- Common Name: Human immunodeficiency virus type 1 (BRU ISOLATE)
- GenBank Taxonomy No.: 11686
- Parents: Human immunodeficiency virus
- Description: We designate our different AIDS virus isolates by three letters of patients names, lymphadenopathy-associated virus (LAV) BRU referring to the prototype AIDS virus isolated in 1983 from a French homosexual patient with lymphadenopathy syndrome (LAS), thought to have been previously infected in the USA(Alizon et al., 1986).
- Human immunodeficiency virus type 1 (CDC-451 ISOLATE) (Website 12):
- Common Name: Human immunodeficiency virus type 1 (CDC-451 ISOLATE)
- GenBank Taxonomy No.: 11687
- Parents: Human immunodeficiency virus
- Description: The lymphotropic retrovirus designated as HIV (CDC-451) was isolated from a 16-year-old white male with severe hemophilia A. Throughout his life, he had been treated with lyophilized factor VIII concentrates. He had no other known risk factors. Just before his death in June 1984, the virus was isolated from his peripheral blood by previously described methods. After two passages in phytohemagglutinin-stimulated normal adult human T cells, the virus was further propagated in Hut-78 cells obtained from the American Type Culture Collection(Desai et al., 1986).
- Human immunodeficiency virus type 1 (CLONE 12 ISOLATE) (Website 13):
- Human immunodeficiency virus type 1 (ELI ISOLATE) (Website 14):
- Common Name: Human immunodeficiency virus type 1 (ELI ISOLATE)
- GenBank Taxonomy No.: 11689
- Parents: Human immunodeficiency virus
- Description: Both of the African patients originated from Zaire; lymphadenopathy-associated virus (LAV) ELI was recovered in 1983 from a 24 year old woman with AIDS(Alizon et al., 1986).
- Human immunodeficiency virus type 1 (HXB2 ISOLATE) (Website 15):
- Common Name: Human immunodeficiency virus type 1 (HXB2 ISOLATE)
- GenBank Taxonomy No.: 11706
- Parents: Human immunodeficiency virus
- Description: Clone HXB2 was derived from a recombinant phage library of XbaI-digested DNA from HTLV-III-infected H9 cell cloned in lambda-J1(Ratner et al., 1985).
- Human immunodeficiency virus type 1 (HXB3 ISOLATE) (Website 16):
- Common Name: Human immunodeficiency virus type 1 (HXB3 ISOLATE)
- GenBank Taxonomy No.: 11707
- Parents: Human immunodeficiency virus
- Description: The integrated proviral genome of HTLV-III was recently cloned from the genomic DNA of H9 cells infected with HTLV-III. Since the HTLV-III provirus was found to lack Xba I restriction sites, a genomic library was constructed using Xba I digested H9/HTLV-III DNA. Screening of this library with HTLV-III cDNA probes yielded several clones, one of which, termed HXB-3 was used in the present study. Approximately 3% divergence was observed between the HTLV-III (HXB-3) and LAV amino acid sequences. However, among the three HTLV-III sequences (HXB-3, HB-10, BH-8), the divergence was 1.6%. Approximately 17% divergence was observed between HXB-3 and ARV-2 sequences, which was most pronounced in the extracellular region of the envelope protein. The observed differences in sequence probably reflect divergent evolution of strains separated in time and geography. ARV-2 was recently isolated from the west coast of the United States. The HTLV-III isolates for which nucleotide sequences have been determined were all obtained from the east coast about one year earlier. Regardless of the reasons, the fact that such divergence can occur, and that it is more pronounced in the extracellular portion of the envelope protein, is an important consideration in the design of both diagnostic reagents and possible vaccines(Crowl et al., 1985).
- Human immunodeficiency virus type 1 (JH3 ISOLATE) (Website 17):
- Common Name: Human immunodeficiency virus type 1 (JH3 ISOLATE)
- GenBank Taxonomy No.: 11694
- Parents: Human immunodeficiency virus
- Description: A strain of HIV-1 JH3 was isolated from a Japanese male 10 years old with hemophilia who was a carrier of HIV at the time of virus isolation (August 1986). Peripheral lymphocytes were cocultured with a human T cell line CEM under the standard conditions, and the virus replicated in CEM cells was termed JH3(Komiyama et al., 1989).
- Human immunodeficiency virus type 1 (JRCSF ISOLATE) (Website 18):
- Common Name: Human immunodeficiency virus type 1 (JRCSF ISOLATE)
- GenBank Taxonomy No.: 11688
- Parents: Human immunodeficiency virus
- Description: Patient J.R. died with Kaposis sarcoma and severe AIDS encephalopathy. The brain showed extensive leukoencephalopathy, and characteristic multinucleated giant cell syncytia were observed in pathologic specimens of frontal lobe brain tissue taken at autopsy. Virus was isolated from various tissue sources by infection of lectin-activated normal human peripheral blood lymphocytes (PBL). Two genotypically distinct viruses were obtained from the CNS of patient J.R. We will term these viruses HIV (JR-CSF) and HIV (JR-FL) for isolates derived from the cerebrospinal fluid and frontal lobe, respectively(Koyanagi et al., 1987).
- Human immunodeficiency virus type 1 (KB-1 ISOLATE) (Website 19):
- Common Name: Human immunodeficiency virus type 1 (KB-1 ISOLATE)
- GenBank Taxonomy No.: 36375
- Parents: Human immunodeficiency virus
- Description: HIV-1 strain KB-1gp41 was isolated from a Japanese male-hemophiliac by coculture of his peripheral blood mononuclear cells (PBMCs) with MT-2 cells(Shimizu et al., 1992).
- Human immunodeficiency virus type 1 (Lai ISOLATE) (Website 20):
- Human immunodeficiency virus type 1 (MAL ISOLATE) (Website 21):
- Common Name: Human immunodeficiency virus type 1 (MAL ISOLATE)
- GenBank Taxonomy No.: 11697
- Parents: Human immunodeficiency virus
- Description: Both of the African patients originated from Zaire; lymphadenopathy-associated virus (LAV) MAL in 1985 from a 7 year old boy with AIDS-related complex (ARC), probably infected in 1981 after a blood transfusion in Zaire, since his parents were LAV-seronegative(Alizon et al., 1986).
- Human immunodeficiency virus type 1 (MFA ISOLATE) (Website 22):
- Common Name: Human immunodeficiency virus type 1 (MFA ISOLATE)
- GenBank Taxonomy No.: 11704
- Parents: Human immunodeficiency virus
- Description: The primary virus isolate was obtained by cocultivation of peripheral blood lymphocytes from an HIV-1-seropositive asymptomatic hemophiliac with cells of the CD4+ cell line CEM(Stevenson et al., 1990).
- Human immunodeficiency virus type 1 (MN ISOLATE) (Website 23):
- Common Name: Human immunodeficiency virus type 1 (MN ISOLATE)
- GenBank Taxonomy No.: 11696
- Parents: Human immunodeficiency virus
- Description: The HIV-1 isolates HTLV-III(MN) and (SC) were obtained from a pediatric AIDS patient in the New York area in 1984 and a homosexual ARC (AIDS-related complex) patient from California in 1984, respectively. In the more constant regions of the env gene, HTLV-III(MN) and (SC), differ mostly by scattered point mutations, many of them resulting in conservative amino acid substitutions. A comparison of the inferred amino acid sequences of the env genes of other HIV-1 isolates for which DNA sequence data are available indicates that HTLV-III(MN) and (SC) differ over the entire length of their env genes from other US isolates to the same extent that they differ from HTLV-III (BH10) and to a significantly greater extent from several African isolates. They thus represent two new env genotypes of HIV-1(Gurgo et al., 1988).
- Human immunodeficiency virus type 1 (NDK ISOLATE) (Website 24):
- Common Name: Human immunodeficiency virus type 1 (NDK ISOLATE)
- GenBank Taxonomy No.: 11695
- Parents: Human immunodeficiency virus
- Description: A highly cytopathic strain of HIV1, named HIV1-NDK, has been isolated from a Zairian patient affected with AIDS. This isolate is 10(4) times more cytopathic and infectious than the prototype. To correlate the high cytopathic properties of this strain with genetic variations, we have cloned and sequenced the genome of this isolate. The principal feature which could be drawn from the fine analysis of the HIV1-NDK sequence is that the variability is not clustered in one particular region but rather spread out all along the genome. Only minor differences seem to be responsible for the acute biological effect of HIV1-NDK(Spire et al., 1989).
- Human immunodeficiency virus type 1 (NEW YORK-5 ISOLATE) (Website 25):
- Common Name: Human immunodeficiency virus type 1 (NEW YORK-5 ISOLATE)
- GenBank Taxonomy No.: 11698
- Parents: Human immunodeficiency virus
- Description: Peripheral blood lymphocytes (PBL) were obtained from five New York City patients in October 1984, from three Zairian patients in October 1983, and from a patient living in Birmingham, Alabama in January 1985. The New York 5 isolate was from a man with AIDS(Benn et al., 1985).
- Human immunodeficiency virus type 1 (NIT-A ISOLATE) (Website 26):
- Common Name: Human immunodeficiency virus type 1 (NIT-A ISOLATE)
- GenBank Taxonomy No.: 36376
- Parents: Human immunodeficiency virus
- Description: We have previously described the isolation and molecular cloning of a family of HIV-1 isolates (HIV-1/N1T) from an individual with lymphadenopathy. Among these viruses, N1T-A behaves like prototypical HIV-1 isolates; its infection is rapid and cytopathic. N1T-E displays slow kinetics of infection and is not cytopathic, but like N1T-A, it is capable of efficient fusion and entry into target cells, expresses a transcriptionally active long terminal repeat (LTR) element, has functional tat and rev genes, and is highly productive in chronic infection in T lymphocytes and monocytes. Like other multiple isolates from one individual, N1T-E and N1T-A have similar restriction endonuclease maps and thus are closely related(Sakai et al., 1991).
- Human immunodeficiency virus type 1 (OYI ISOLATE) (Website 27):
- Common Name: Human immunodeficiency virus type 1 (OYI ISOLATE)
- GenBank Taxonomy No.: 11699
- Parents: Human immunodeficiency virus
- Description: An unusual HIV-1 strain has been isolated from the blood of a healthy Gabonese individual who presented an atypical western blot (WB). This virus, identified as isolated HIV-1OYl, grew to low titres of reverse transcriptase activity (less than 50,000 cpm/ml) and was not obviously cytopathic. Radioimmunoprecipitation and peptide ELISA studies indicated that the lack of env-specific reactivity was probably due to the absence of antibodies to the viral glycoproteins, rather than the virus encoding a highly divergent envelope protein(Huet et al., 1989).
- Human immunodeficiency virus type 1 (PV22 ISOLATE) (Website 28):
- Human immunodeficiency virus type 1 (RF/HAT ISOLATE) (Website 29):
- Common Name: Human immunodeficiency virus type 1 (RF/HAT ISOLATE)
- GenBank Taxonomy No.: 11701
- Parents: Human immunodeficiency virus
- Description: A strain of HTLV-III was isolated from fresh mononuclear cells from the peripheral blood of a Haitian patient, R. F., who was diagnosed with AIDS acquired through heterosexual transmission(Popovic et al., 1984).
- Human immunodeficiency virus type 1 (SC ISOLATE) (Website 30):
- Common Name: Human immunodeficiency virus type 1 (SC ISOLATE)
- GenBank Taxonomy No.: 11702
- Parents: Human immunodeficiency virus
- Description: The HIV-1 isolates HTLV-III(MN) and (SC) were obtained from a pediatric AIDS patient in the New York area in 1984 and a homosexual ARC (AIDS-related complex) patient from California in 1984, respectively. In the more constant regions of the env gene, HTLV-III(MN) and (SC), differ mostly by scattered point mutations, many of them resulting in conservative amino acid substitutions. A comparison of the inferred amino acid sequences of the env genes of other HIV-1 isolates for which DNA sequence data are available indicates that HTLV-III(MN) and (SC) differ over the entire length of their env genes from other US isolates to the same extent that they differ from HTLV-III (BH10) and to a significantly greater extent from several African isolates. They thus represent two new env genotypes of HIV-1(Gurgo et al., 1988).
- Human immunodeficiency virus type 1 (SF162 ISOLATE) (Website 31):
- Common Name: Human immunodeficiency virus type 1 (SF162 ISOLATE)
- GenBank Taxonomy No.: 11691
- Parents: Human immunodeficiency virus
- Description: HIV-1 SF162 was obtained by cocultivation of peripheral blood mononuclear cells (PMC) from seronegative donors with cerebrospinal cord fluid of a HIV-1-seropositive patient with toxoplasmosis(Cheng-Mayer et al., 1990).
- Human immunodeficiency virus type 1 (SF33 ISOLATE) (Website 32):
- Common Name: Human immunodeficiency virus type 1 (SF33 ISOLATE)
- GenBank Taxonomy No.: 11690
- Parents: Human immunodeficiency virus
- Description: HIV-l SF33 was obtained from the PMC of a patient with thrombocytopenia. The HIV-1 SF33 strain replicates rapidly and to high titers in the HUT 78 and CEM cell lines and productively infects HOS cells. This isolate is also very cytopathic and forms plaques in the MT-4 cell line. The molecular clones of HIV-l SF2 and HIV-l SF33 were found to be biologically active upon transfection into human rhabdomyosarcoma (RD-4) and HUT 78 cells. The biologic properties of the molecular clones showed characteristics identical to those of the parental viruses(York-Higgins et al., 1990).
- Human immunodeficiency virus type 1 (STRAIN UGANDAN / ISOLATE U455) (Website 33):
- Common Name: Human immunodeficiency virus type 1 (STRAIN UGANDAN / ISOLATE U455)
- GenBank Taxonomy No.: 11703
- Parents: Human immunodeficiency virus
- Description: U455 virus was isolated in December 1985 from peripheral blood lymphocytes (PBL) of a 35-year-old Ugandan male diagnosed to have slim disease and tuberculosis. We have made a large number of isolations of HIV-1 from seropositive asymptomatic individuals and from patients with slim disease, chiefly from the Kampala region of Uganda. We now describe the isolation and properties of a Ugandan virus(Oram et al., 1990).
- Human immunodeficiency virus type 1 (WMJ1 ISOLATE) (Website 34):
- Common Name: Human immunodeficiency virus type 1 (WMJ1 ISOLATE)
- GenBank Taxonomy No.: 31678
- Parents: Human immunodeficiency virus
- Description: Isolate WMJ-1 was similarly transmitted from the peripheral blood mononuclear cells of a Haitian infant with AIDS to an immortalized T cell line(Starcich et al., 1986).
- Human immunodeficiency virus type 1 (WMJ2 ISOLATE) (Website 35):
- Human immunodeficiency virus type 1 (YU-2 ISOLATE) (Website 36):
- Common Name: Human immunodeficiency virus type 1 (YU-2 ISOLATE)
- GenBank Taxonomy No.: 36377
- Parents: Human immunodeficiency virus
- Description: The viral clones HIV-1YU-2, HIV-l Yu-1 , HIV-1YU 21, and HIV-1YU-32 analyzed in this study were obtained as described previously directly from uncultured brain tissue of a man who died in 1986 at the age of 40 with severe (stage 3) ADC. Although the date of initial HIV-1 infection of this individual was unknown, he first presented with an AIDS-defining illness (Kaposi's sarcoma) in 1983 and then developed extraoral candidiasis, cytomegalovirus retinitis, and Pneumocystis carnii pneumonia in 1985. He never received AZT or other antiretroviral therapy. Immunohistological examination of the brain described previously revealed severe multinucleated giant cell encephalitis and widespread HIV-1 infection of macrophages and microglia. Because the HIV-1 clones were derived from this tissue by recombinant lambda phage cloning of permuted circular viral DNA intermediate forms, the viral inserts were excised by using unique restriction endonucleases (SailI, SphIT, and EcoRI) and reconstructed in the plasmid vector pTZ so as to yield full-length nonpermuted viral genomes(Li et al., 2002).
- Human immunodeficiency virus type 1 (Z-84 ISOLATE) (Website 37):
- Common Name: Human immunodeficiency virus type 1 (Z-84 ISOLATE)
- GenBank Taxonomy No.: 11681
- Parents: Human immunodeficiency virus
- Description: Peripheral mononuclear cells were isolated from a Zairian male with the acquired immunodeficiency syndrome (AIDS), age 52, phytohemagglutinin (PHA)-stimulated, and cocultivated with PHA-stimulated normal donor perhipheral mononuclear cells under standard conditions. H9 cells were infected with cell-free supernatant from the mononuclear cell cultures. This isolate of HIV-1, termed Z84, has been maintained in H9 cells(Yourno et al., 1988).
- Human immunodeficiency virus type 1 (Z2/CDC-Z34 ISOLATE) (Website 38):
- Human immunodeficiency virus type 1 (ZAIRE 3 ISOLATE) (Website 39):
- Human immunodeficiency virus type 1 (ZAIRE 6 ISOLATE) (Website 40):
- Common Name: Human immunodeficiency virus type 1 (ZAIRE 6 ISOLATE)
- GenBank Taxonomy No.: 11708
- Parents: Human immunodeficiency virus
- Description: We molecularly cloned the genome of HIV isolated from a Zairian AIDS patient. Restriction mapping of the recombinant clone, designated HIV-Zr6, revealed both common (as observed in other HIV isolates) and unique restriction sites. The DNA clone of HIV-Zr6, shown to give rise to infectious cytopathic virus after transfection of cultured lymphoid cells, was sequenced in several regions. The long terminal repeat (LTR), open reading frame 1 (ORF1), C-terminal envelope (env) gene domain, and ORF2 showed less than 6% difference in nucleotide sequence when compared to other HIV isolates including human T-lymphotropic virus-type III (HTLV-III) clone B10, lymphadenopathy-associated virus-1 (LAV-1), and AIDS-associated retrovirus-2 (ARV-2)(Srinivasan et al., 1987).
- Human immunodeficiency virus type 1 (ZAIRE HZ321 ISOLATE) (Website 41):
- Common Name: Human immunodeficiency virus type 1 (ZAIRE HZ321 ISOLATE)
- GenBank Taxonomy No.: 11692
- Parents: Human immunodeficiency virus
- Description: Human immunodeficiency virus type 1 (Z321 designate, HIV-1Z321), the oldest known HIV, was isolated from a serum sample collected in Zaire in 1976 and was molecularly cloned(Srinivasan et al., 1989).
- Human immunodeficiency virus type 1 (lw12.3 ISOLATE) (Website 42):
- Common Name: Human immunodeficiency virus type 1 (lw12.3 ISOLATE)
- GenBank Taxonomy No.: 82834
- Parents: Human immunodeficiency virus
- Description: Accidental infection of a laboratory worker (LW) with HIV-1 has been previously reported. LW was involved in high-volume production of concentrated HIV-1 (human T cell leukemia/lymphotropic virus [HTLV]-III). Although no obvious exposure incident could be documented and no symptoms of an acute HIV-1 seroconversion syndrome were apparent, seropositivity was noted during routine screening, and virus was subsequently isolated. HIV-1 isolates were established and grown at various times from September 1985 to February 1990 in three independent laboratories from the peripheral blood mononuclear cells (PBMCs) of LW(Reitz et al., 1994).
- Human immunodeficiency virus type 2 (BEN ISOLATE) (Website 43):
- Common Name: Human immunodeficiency virus type 2 (BEN ISOLATE)
- GenBank Taxonomy No.: 11714
- Parents: Human immunodeficiency virus
- Description: A HIV-2 strain named HIV-2ben was isolated from peripheral blood lymphocytes of a patient who, since 1984, had developed neurological symptoms such as Raynaud's syndrome, followed by paresthesia of extremities and ataxia, and finally paraparesis of the legs and incontinence. This new isolate could be distinguished from HIV-2rod by antibody-binding epitopes, peptide maps of core p24 and p18 polypeptides and restriction endonuclease cleavage pattern(Schneider et al., 1990).
- Human immunodeficiency virus type 2 (CAM2 ISOLATE) (Website 44):
- Common Name: Human immunodeficiency virus type 2 (CAM2 ISOLATE)
- GenBank Taxonomy No.: 11715
- Parents: Human immunodeficiency virus
- Description: We report the complete nucleotide sequence of a human immunodeficiency virus type 2 (HIV-2) isolate from Guinea-Bissau (HIV-2CAM2). The genomic organization of HIV-2CAM2 is identical to that of other HIV-2 isolates but contains a stop codon in the pol gene. The deduced amino acid sequences of the viral proteins show variation of 20% in the gag, pol and vpx regions, and 25 to 45% in the tat, env and nef regions when compared to other isolates of HIV-2. This is greater than the variation observed between isolates of HIV-1(Tristem et al., 1991).
- Human immunodeficiency virus type 2 (D194 ISOLATE) (Website 45):
- Common Name: Human immunodeficiency virus type 2 (D194 ISOLATE)
- GenBank Taxonomy No.: 11713
- Parents: Human immunodeficiency virus
- Description: HIV-2 D194 was isolated in 1987 from the peripheral blood of a Gambian male who lived in Germany since May 1986. The patient suffered from severe neurological symptoms (Neuro-AIDS) and died at the end of May 1987. The virus isolate is characterized by its excellent growth in cultivated primary human macrophages(Kuhnel et al., 1990).
- Human immunodeficiency virus type 2 (D205,7 ISOLATE) (Website 46):
- Common Name: Human immunodeficiency virus type 2 (D205,7 ISOLATE)
- GenBank Taxonomy No.: 11716
- Parents: Human immunodeficiency virus
- Description: We have previously reported the molecular cloning of HIV-2 D205. This isolate from a healthy woman from Ghana was biologically characterized by its good growth on macrophages and by the absence of cytopathic effects on lymphocytes. It was originally classified as HIV-2 by western blot analysis. We have now determined the complete nucleotide sequence of the clone HIV-2 D205.7, which encompasses 7,817 base pairs (bp) of the proviral genome starting form the left lont terminal repeat (LTR)(Dietrich et al., 1998).
- Human immunodeficiency virus type 2 (GHANA-1 ISOLATE) (Website 47):
- Common Name: Human immunodeficiency virus type 2 (GHANA-1 ISOLATE)
- GenBank Taxonomy No.: 11717
- Parents: Human immunodeficiency virus
- Description: We isolated a retrovirus that hybridized with an HIV-2 ROD probe from an AIDS patient in Ghana and named it HIV-2[GH-1]. The restriction endonuclease patterns of the HIV-2[GH-1] were quite different from those of HIV-2[ROD](Hasegawa et al., 1989).
- Human immunodeficiency virus type 2 (KR ISOLATE) (Website 48a):
- Human immunodeficiency virus type 2 (NIH-Z ISOLATE) (Website 48b):
- Human immunodeficiency virus type 2 (ROD ISOLATE) (Website 49):
- Common Name: Human immunodeficiency virus type 2 (ROD ISOLATE)
- GenBank Taxonomy No.: 11720
- Parents: Human immunodeficiency virus
- Description: The ROD isolate of HIV-2 was obtained in 1985 from an AIDS patient from Cape Verde Islands (offshore Senegal)(Guyader et al., 1987).
- Human immunodeficiency virus type 2 (SBL/ISY ISOLATE) (Website 50):
- Common Name: Human immunodeficiency virus type 2 (SBL/ISY ISOLATE)
- GenBank Taxonomy No.: 11718
- Parents: Human immunodeficiency virus
- Description: The comparison of the predicted amino acid sequence of the viral proteins of HIV-2 SBL/ISY revealed a divergence comparable to the divergence observed among HIV-1 Zairian isolates, which is higher than the divergence described among American isolates. The patients from whom the HIV-2 isolates were obtained originated from geographically neighboring African countries of Guinea Bissau (HIV-2 NIH-z), Cape Verde Islands (HIV-2 ROD), and Gambia (HIV- 2 SBL/ISY). The considerable degree of divergence among these HIV-2 isolates would suggest that HIV-2 has been present in the African population for a time similar to HIV-1(Franchini et al., 1989). In fact, the infectivity of HIV-2 SBL/ISY is not restricted to human cells, but we have shown in a parallel study that this virus infects and kills fresh peripheral blood T cells from rhesus macaques in vitro and infects the same animals in vivo(Franchini et al., 1989).
- Human immunodeficiency virus type 2 (ST ISOLATE) (Website 51):
- Common Name: Human immunodeficiency virus type 2 (ST ISOLATE)
- GenBank Taxonomy No.: 11721
- Parents: Human immunodeficiency virus
- Description: To elucidate determinants of HIV pathogenicity, we have begun to molecularly dissect a previously reported, nonfusogenic and noncytopathic HIV-2 isolate, termed HIV-2/ST, that was obtained from a healthy Senegalese prostitute. Although this virus replicated to high titers in tissue culture, it infected cells at a slower rate than did cytopathic strains of HIV-1 and HIV-2 and caused little or no cell killing and fusion. This was the case despite the fact that its external envelope glycoprotein was cleaved correctly, transported to the cell surface, and shown to bind to a specific epitope on CD4, which was recognized by OKT4a but not OKT4 antibodies. HIV-2/ST therefore appeared to bind to the CD4 molecule analogous to other HIVs, but it failed to fuse with CD4-bearing target cells, suggesting that its infectivity was greatly retarded at the level of cell entry(Kumar et al., 1990).
- Human immunodeficiency virus type 2 (ST/24.1C#2 ISOLATE) (Website 52):
- Common Name: Human immunodeficiency virus type 2 (ST/24.1C#2 ISOLATE)
- GenBank Taxonomy No.: 31681
- Parents: Human immunodeficiency virus
- Description: The present study was undertaken to investigate the glycoprotein regions responsible for differential syncytium formation by two genetically highly related but biologically distinct HIV-2 viruses. Recombinant vaccinia virus expresson of the env gene of HIV-2/ST (ST) (a previously described replication-competent but noncytopathic virus) indicated that the glycoprotein was deficient in syncytium formation. Compared with wild-type ST, the env protein of a molecularly cloned cytopathic ST variant, designated HIV-2/ST/24.1C#2, cased more efficient syncytium formation in the human T-cell line Sup T1, in which the variant was originally generated by repeated passage(Mulligan et al., 1992).
- Human immunodeficiency virus type 2 (D205 ISOLATE) (Website 53):
- Common Name: Human immunodeficiency virus type 2 (D205 ISOLATE)
- GenBank Taxonomy No.: 11710
- Parents: Human immunodeficiency virus
- Description: It has been suggested that the human immunodeficiency virus type 2 (HIV-2) and the simian immunodeficiency virus from rhesus macaques (SIV-mac) evolved from the sooty mangabey virus (SIV-sm). We now describe an HIV-2-related isolated, HIV-2 D205 from a health Ghanaian woman that is genetically equidistant to the prototypic HIV-2 strains and to SIV-sm and SIV-mac. Supported by the observation that HIV-2 D205 differs in a step of envelope glycoprotein processing, our data indicate that it could represent an alternative HIV-2 subtype and that viruses of the HIV-2 / SIV-sm / SIV-mac group could have already infected humans before HIV-2 and SIV-sm / SIV-mac diverged(Dietrich et al., 2002).
- Human immunodeficiency virus type 2 (EHOISOLATE) (Website 54):
- Common Name: Human immunodeficiency virus type 2 (EHOISOLATE)
- Parents: Human immunodeficiency virus
- Description: HIV-2 EHO was initially isolated from peripheral blood lymphocytes of a patient from Ivory Coast with full-blown AIDS. This isolate manifested tropism for stimulated normal human lymphocytes and to neoplastic lymphoid or monocytoid (U937) cell lines. The affinity of HIV-2 EHO particles to bind soluble CD4 molecules was found to be severalfold higher compared to HIV-2 ROD(Rey-Cuille et al., 1994).
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Lifecycle Information
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- Stage Information:
- Immature Virion:
- Size: 100 nm in diameter
- Shape: Budding particles are much more rigid than mature particles, which often have a wrinkled envelope. As the budding process proceeds, one sees progressively more and more of a thin zone of electron density situated under the portion of the cells unit membrane that is being usurped by the developing virus. Simultaneously with the budding, spikes (gp 120) are being inserted into the membrane and appear on the surface of the developing virion envelope. This budding process continues until the virus has formed a complete sphere, i.e., the immature particle
- Mature HIV particle:
- Size: 100 nm in diameter
- Shape: Morphologically, HIV, like all of the Lentiviruses or slow viruses, has an asymmetric core, whose appearance depends on the plane of sectioning. The conical capsid in the mature HIV particle has an electron-dense broad end and a hollow tapered end. Depending on where the core is sectioned and its orientation in the field of view, one sees a hollow or dense spherical structure, when it is cut in cross section, or degrees of foreshortening of the conical core in tangential sections
- Progression Information:
- Maturation:
- From Stage: Immature Virion
- To Stage: Mature HIV particle
- Picture(s):
- Description: Details on the sequence of events during HIV-1 assembly and maturation first emerged from electron microscopy studies. Large Gag complexes were visualized under the plasma membrane followed by the appearance of the spheres connected to the cell by a thin stalk. The nascent immature virions contained an electrondense layer under the lipid envelope and had a doughnut-shaped appearance. The maturation process changed the arrangment of the structural components inside the virion: the radially arranged Gag molecules were dismantled, and a conical core structurewas assembled in the center of the viral particle. It now appears that in immature HIV-1 particles Gag polyprotein is radially arranged under the virus membrane, the N termini lie at the membrane and the C termini extend toward the center of the particle. The MA domain is tightly associated with the inner face of the viral membrane and separated from the capsid layer by a low density region corresponding to its C terminus. Such organization of the MA layer stabilizes the viral membrane. The CA and NC domains form regular layers which contribute to the radial density to the immature particle. According to the generally accepted view, structural changes coupled with virus maturation are induced by proteolytic processing of Gag p55 by the viral protease during or after budding of the virus particles. As with all retroviruses, HIV-1 protease is an aspartic protease and is functional only as a dimer. Activation of protease is a critical step in HIV-1 morphogenesis. Cleavage of Gag and Gag-Pol precursors is necessary for virus maturation and infectivity, and mutation or inhibition of protease abolishes production of infectious virus. It is widely accepted that the cleavage of Gag p55 induces major structural rearrangements in the virus particle, and that the last step of cleavage between CA and p2 triggers the condensation of NC and the RNA genome into a cone-shape core whileCAforms the shell. This rearrangement is necessary for virus infectivity(Bukrinskaya, 2004).
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Genome Summary
- Genome of Human immunodeficiency virus(Website 55)
- Description: INTIAL SEQUENCE DESCRIPTION: A number of different recombinant DNA clones of HTLV-III/LAV have been obtained and analyzed by restriction enzyme digestion and/or nucleotide sequencing. This work has demonstrated that the viral genome is 9182-9213 nucleotides in length, with long terminal repeats (LTRs) of 636-637 nucleotides, and at least seven genes. Three replicative genes include gag, pol, and env, which are similar to those in other retroviruses, though env is longer than that of other retroviruses. A fourth gene, designated tat, is structurally distinct from that of other retroviruses, and encodes a trans-acting factor capable of enhancing virus expression in a positive feedback manner. A fifth gene has recently been identified, and has been named art or anti-repressor of transactivation or trs or trans-repressor of splicing. Two additional genes, designated short open reading frame (sor) and 3 open reading frame (3'orf) are also unique to HTLV-III/LAV, but the functions of their gene products are unknown. An additional open reading frame, designated R, is also presumed to encode a protein product based on the finding of antibodies in infected individuals reactive to these sequences expressed in E. coli(Ratner et al., 1987).
- HIV-1(Website 55)
- GenBank Accession Number: NC_001802
- Size: 9181bp(Website 55).
- Gene Count: 9(Retroviruses, 1997).
- Description: OVERVIEW: Most replication competent retroviruses depend on three genes: gag, pol and env : gag means "group-antigen", pol represents "polymerase" and env is for "envelope". The "classical" structural scheme of a retroviral genome is: 5'LTR-gag-pol-env-LTR 3'. The LTR ("long terminal repeat") regions represent the two end parts of the viral genome that are connected to the cellular DNA of the host cell after integration and do not encode for any viral proteins. The gag and env genes code for the nucleocapsid and the glycoproteins of the viral membrane; the pol gene codes for the reverse transcriptase and other enzymes. In addition, HIV-1 contains in its 9kB RNA six genes (vif, vpu, vpr, tat, rev and nef) that contribute to its genetic complexity. Nef, vif, vpr and vpu were classified as accessory genes in the past, as they are not absolutely required for replication in vitro. However, the regulation and function of these accessory genes and their proteins have been studied and characterized in more detail within the last years(Kamps and Hoffman, 2003). DESCRIPTION OF PROTEINS - gag: (336-1836) The gag region encodes Pr55 Gag. Pr55 Gag is myristylated at the 2Gly position. Proteolytic processing cleaves p17 MA, p24 CA, p7 NC and p2 from Pr55 Gag(Retroviruses, 1997). pol: (2102-4640) The pol ORF is in-frame with the pro ORF; pol gene products are synthesized as part of the Pr160 Gag-Pro-Pol polyprotein. RT is a p66/p51 heterodimer, the two subunits of which differ by the presence or absence of most of the RNase H domain. P32 IN is cleaved from the carboxy-terminal region of Pr160 Gag-Pro-Pol. Integration of HIV-1 DNA produces a 5-bp duplication of flanking cellular DNA(Retroviruses, 1997). vif: (4587-5163) The p23 Vif protein is translated from a singly spliced mRNA(Retroviruses, 1997). vpr: (5105-5339) The p15 Vpr protein is translated from a singly spliced mRNA. Vpr is found at the inner face of the cell membrane in infected cells. Large amounts of Vpr are packaged in virions, although it is not a structural protein(Retroviruses, 1997). tat: (5377-5991, 7925-7968) The p14 Tat protein is translated from multiply spliced mRNAs. Tat is localized in the nucleus of infected cells and activates viral transcription by binding to the TAR region of R. Tat is active as a homodimer and is phosphorylated in its carboxy-terminal region, although the functions of this modification is not known(Retroviruses, 1997). rev: (5516-5591, 7925-8197) The rev ORF spans exons 2 and 3 of a multiply spliced mRNA and encodes the Rev protein (p19). Rev localizes in the nucleus and is phosphorylated on serine residues. Rev binds the RRE (bases 7315-7548) present in intron-containing RNAs, facilitating mRNA transport to the cytoplasm(Retroviruses, 1997). vpu: (5608-5854) The vpu ORF is expressed from a weak initiation (AUG) codon upstream of the env AUG and encodes p16 Vpu. Vpu is phosphorylated on serine residues and localizes to the plasma cell membrane, but is not found in virions(Retroviruses, 1997). env: (5771-8339) The env ORF encodes the gPr160 Env polyprotein precursor that is processed by cellular proteases to generate mature gp120 SU and gp41 TM. The SU protein contains alternating conserved and variable (V) regions. SU mediates HIV-1 adsorption through the coordinate binding to host cell CD4 molecules and to one of several host cell coreceptors. Although the env genes of HIV1 have been extensively sequenced, the only known HIV env structure is the coiled-coil region of TM. The SU/TM pair is thought to form trimers on the virion membrane. There are 24 sites for N-linked glycosylation in SU. There are seven glycosylation sites in TM(Retroviruses, 1997). nef: (8343-8710) The nef ORF lies immedioately downstream from the env ORG and extends into the U3 region of the 3 LTR. P27 Nef is translated from a multiply spliced subgenomic mRNA. It undergoes posttranslational myristylation at the 2 Gly position which helps to localize Nef to the inner aspect of the cell membrane. Nef forms homodimers and is phosphorylated at 15Tyr(Retroviruses, 1997).
- Picture(s):
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Human immunodeficiency virus 1, complete genome (Website 55)
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Human immunodeficiency virus 1, complete genome (Website 55)
- Genome of Human immunodeficiency virus type 2(Website 56)
- Description: Human immunodeficiency virus type 2 (HIV-2) shares many of the same biological properties with the well-studied HIV-1. Both are associated with acquired immunodeficiency syndrome (AIDS) in humans, are cytopathic in tissue culture, and have a tropism for CD4+ subset of T cells, macrophages, and other cells. Concordantly, their genome organization is quite similar and unique among retroviruses. The common feature of HIV genomes is the abundance of open reading frames (ORFs) not found in other retroviruses. In addition to three structural genes (gag, pol, env), there are several extra ORFs. ORFs designated as vif, vpr, tat, rev, and nef are common to HIV-1 and HIV-2. functional analyses of the HIV-1 genome have revealed the functions of these ORFs. In spite of the structural similarity of the genome, the nucleotide sequences and predicted amino acid sequences of these two viruses differ significantly, and furthermore, there is an unique ORF in each virus (vpu, unique to HIV-1, and vpx, unique to HIV-2)(Shibata et al., 1990). Nucleotide sequence comparison between HIV-1, HIV-2 and SIV has revealed the presence of an open reading frame (ORF) in the central region of the genomes of HIV-2 and SIV that has no counterpart in HIV-1. This new ORF, called vpx, is highly conserved between HIV-2ROD and SIVmac. Using anti-peptide sera to the predicted protein and site-directed mutagenesis, we show that mutations in the vpx ORF eliminate the synthesis of a 16 kd protein in HIV-2 infected cells, confirming that this protein is the product of this gene. Full-length clones of HIV-2 containing these mutations are infectious in two permanent T lymphocytic cell lines and two monocytic cell lines. In contrast, we show that loss of VPX function results in a severe defect in the productive infection of human peripheral blood lymphocytes both in the amount of reverse transcriptase activity produced and in core protein expression. These findings suggest that the VPX protein plays an important role in the in vivo life cycle of the HIV-2/SIV viruses(Guyader et al., 1989). Antibody reactivity to the orf-x product was detected in 35 of 42 HIV-2 positive serum samples and 11 of 52 SIV seropositive monkeys. No such antibodies were detected in HIV-1 positive donors, blood donors seronegative for both HIV-2 and HIV-1, or SIV seronegative monkeys. This suggests that orf-x is dispensable for in vitro replication of SIVMAC and that the orf-x gene product of HIV-2 or its antibody can be used to distinguish HIV-2 from HIV-1 infection(Yu et al., 1988).
- HIV-2(Website 56)
- GenBank Accession Number: NC_001722
- Size: 10359bp(Website 56).
- Gene Count: 9(Website 56).
- Description: Infectious molecular clones of the human immunodeficiency virus type 2 (HIV-2) will be valuable tools for the study of regulatory gene functions and the development of an animal model for the human acquired immunodeficiency syndrome (AIDS). To this end, we have cloned and sequenced a novel HIV-2 isolate, HIV-2BEN. One clone, designated MK6, is infectious for various human T-cell lines and for human and macaque peripheral blood lymphocytes (PBL), allowing molecular studies of HIV-2 infection and replication. Since MK6 is highly cytopathic in MT-2 and Molt-4 clone 8 cells, antiviral agents and neutralizing sera may be tested(Kirchhoff et al., 2002).
- Picture(s):
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Human immunodeficiency virus 2, complete genome (Website 56)
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Human immunodeficiency virus 2, complete genome (Website 56)
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Biosafety Information
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Biosafety information for Human immunodeficiency virus
- Level: 2 and 3(US Department of Health Services, 1999).
- Applicable: HIV has been isolated from blood, semen, saliva, tears, urine, cerebrospinal fluid, amniotic fluid, breast milk, cervical secretion, and tissue of infected persons and experimentally infected nonhuman primates. CDC has recommended that blood and body fluid precautions be used consistently when handling any blood-contaminated specimens. This approach, referred to as "universal precautions," precludes the need to identify clinical specimens obtained from HIV-positive patients or to speculate as to the HIV status of a specimen(US Department of Health Services, 1999).
- Precautions: BSL-2 standard and special practices, containment equipment and facilities are recommended for activities involving all blood-contaminated clinical specimens, body fluids and tissues from all humans, or from HIV- or SIV-infected or inoculated laboratory animals. Activities such as producing research-laboratory-scale quantities of HIV or SIV, manipulating concentrated virus preparations, and conducting procedures that may produce droplets or aerosols, are performed in a BSL-2 facility, but using the additional practices and containment equipment recommended for BSL-3. Activities involving industrial-scale volumes or preparation of concentrated HIV or SIV are conducted in a BSL-3 facility, using BSL-3 practices and containment equipment. Nonhuman primates or other animals infected with HIV or SIV are housed in ABSL-2 facilities using ABSL-2 special practices and containment equipment. In the laboratory, the skin (especially when scratches, cuts, abrasions, dermatitis, or other lesions are present) and mucous membranes of the eye, nose, and mouth should be considered as potential pathways for entry of these retroviruses. Whether infection can occur via the respiratory tract is unknown. The need for using sharps in the laboratory should be evaluated. Needles, sharp instruments, broken glass, and other sharp objects must be carefully handled and properly discarded. Care must be taken to avoid spilling and splashing infected cell-culture liquid and other virus-containing or potentially infected materials(US Department of Health Services, 1999).
- Disposal: Studies have shown that HIV is inactivated rapidly after being exposed to commonly used chemical germicides at concentrations that are much lower than used in practice. Embalming fluids are similar to the types of chemical germicides that have been tested and found to completely inactivate HIV. In addition to commercially available chemical germicides, a solution of sodium hypochlorite (household bleach) prepared daily is an inexpensive and effective germicide. Concentrations ranging from approximately 500 ppm (1:100 dilution of household bleach) sodium hypochlorite to 5,000 ppm (1:10 dilution of household bleach) are effective depending on the amount of organic material (e.g., blood, mucus) present on the surface to be cleaned and disinfected. Commercially available chemical germicides may be more compatible with certain medical devices that might be corroded by repeated exposure to sodium hypochlorite, especially to the 1:10 dilution(MMWR, 1987).
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Culturing Information
- Plasma Culture Assay :
- Description: The quantitative plasma culture assay measures the amount of cell-free infectious HIV in patient plasma - a measure of plasma viremia. The assay is similar in design to that used for quantitative PBMC culture. Each sample of patient plasma is cultured with stimulated HIV-negative donor PBMC for 14 days. The assay is performed in duplicate in a 24-well tissue culture plate with 6 fivefold dilutions of plasma. Supernatant from each individual well is assayed by the standard p24 EIA method to determine positivity and level of produced viral protein. The assay utilizes plasma from citrate heparinized peripheral blood (10 ml). For best results, blood should be processed within 4 to 6 h of draw. Plasma not assayed immediately should be stored at -70C for future use(Hammer et al., 1993). Plasma was obtained by centrifugation of blood at 3000xg for 15 minutes which is sufficient to remove all cells. Decreasing volumes of plasma were cultured with 2x10(6) phytohemagglutinin-activated PBMC from healthy blood-bank donors in 1.5 ml of RPMI-1640 medium with 15 percent fetal-calf serum and 10 percent (vol/vol) interleukin-2. Twenty-four hours later all cultures were washed four times with medium. Cocultures were subsequently monitored for the presence of p24 antigen in supernatant fluid, twice weekly for up to 28 days(Ho and Moudgil, 1989).
- Medium: Decreasing volumes of plasma were cultured with 2x10(6) phytohemagglutinin-activated PBMC from healthy blood-bank donors in 1.5 ml of RPMI-1640 medium with 15 percent fetal-calf serum and 10 percent (vol/vol) interleukin-2(Ho and Moudgil, 1989). For the HIV-1 enhanced detection assay, PBMC were resuspended at a concentration of 10(6) cells/ml in RPMI 1640 medium (Sigma, St. Louis, Mo.) supplemented with 10% heat inactivated fetal calf serum (Sigma), penicillin (50 U/ml), streptomycin (50 mg/ml), L-glutamine (2 mM), HEPES buffer (10 mM), and 100 U of recombinant human interleukin-2 (Hoffmann-La Roche, Nutley, N.J.) per ml(Tremblay et al., 2000).
- Optimal Temperature: Cell cultures were incubated at 37C in a humidified 5% CO2 atmosphere(Tremblay et al., 2000).
- Optimal Humidity: Cell cultures were incubated at 37C in a humidified 5% CO2 atmosphere(Tremblay et al., 2000).
- Peripheral Blood Mononuclear Cell Assay :
- Description: HIV can be cultured from the peripheral blood of virtually all HIV-seropositive patients. However, the number of infected cells in the peripheral blood can vary(Hammer et al., 1993). PROCESSING OF DONOR AND PATIENT PBMCs: 1. Centrifuge anticoagulated blood at 200 x g for 10 minutes at 20 to 24C and remove most of the plasma which should be aliquoted and frozen. 2. To one part centrifuged blood, from which most of the plasma has been removed, add one part diluent (saline or PBS) e.g., 8 mL centrifuged blood to 8 mL diluent. 3. Layer 4 parts of diluted blood over 3 parts lymphocyte separation solution (LSS: Organon or Pharmacia) e.g., 16 mL diluted blood over 12 mL LSS. 4. Centrifuge at 400 x g for 30 minutes at 20 to 24C. Remove PBMCs and wash twice in two volumes of PBS or Hanks BSS. 5. Enumerate cells and adjust sample with culture medium to achieve a concentration of 2 million cells per mL. STIMULATION OF DONOR PBMCs: 1. Stimulation Medium for donor PBMCs: a. RPMI 1640 with glutamine; 20% fetal bovine serum (heat-inactivated); PHA-P (5 ttg/mL, Difco or Sigma); 3% IL-2 (Cellular Products, Electro-Nucleonics, or Boehringer Mannheim); penicillin (100 units/mL)/streptomycin (100 t1g/mL) or gentamicin (50 sg/mL). 2. IL-2 should be a purified, delectinated human preparation, not a recombinant product. Amphotericin B should be avoided as it may inhibit HIV replication. 3. Do not use frozen donor cells or pooled donor PBMCs. 4. Process random donor buffy coats within 12 hours of collection. 5. Maximum PBMC concentration in stimulation culture: 2 million PBMCs/mL. 6. Use only anti-HIV negative donors; culture donor PBMCs separately to verify absence of HIV infectivity.C. HIV COCULTURE PROCEDURE: 1. Coculture Medium for HIV isolation - a. RPMI 1640 with glutamine; 20% fetal bovine serum (heat-inactivated); 5%natural, delectinated IL-2; penicillin/streptomycin or gentamicin (concentrations cited above). 2. Coculture patient PBMCs within 8 hours of processing.3. Sediment 1 to 3 day old stimulated donor PBMCs at 200 x g for 10 minutes at 20 to 24C, remove and discard supernatant, then resuspend cells in coculture medium and enumerate cells. Adjust sample with coculture medium to a concentration of 2 million PBMCs/mL. 4. Maintain equivalent concentrations of donor PBMCs to patient PBMCs e.g., 10 million donor cells to 10 million patient cells in 10 mL medium (final PBMC concentration: 2million PBMCs/mL). 5. Remove one-half volume of coculture medium every 3 to 4 days and replace with an equal volume of fresh medium. The medium is saved at -30C to -80C for HIV p24 antigen determination. 6. Once a week add 10 million, freshly pelleted and enumerated, 1 to 3 day old PHA-stimulateddonor cells (2 million PBMCs/mL), resuspended in coculture medium.D. ASSAYING MEDIUM FOR HIV (p24) ANTIGEN TO DETERMINE HIV REPLICATION: I. Fresh or frozen medium may be tested and clarification is optional(Hollinger et al., 1992).
- Medium: All laboratories but one used RPMI 1640 medium containing glutamine and 10 to 20% heat-inactivated fetal bovine serum. Donor PBMCs should be obtained from the buffy coat of random, seronegative donors and processed within 12 h of collection. A delay of 24h is inadvisable, because recovery is then suboptimal(Hollinger et al., 1992). The assay utilizes heparinized or citrated peripheral blood (20 ml), from which PBMC are isolated by a Ficoll-Hypaque gradient. Blood must be processed within 24 h, and cells not used in the assay are to be frozen in liquid nitrogen(Hammer et al., 1993).
- Optimal Temperature: After 2 to 4 days in culture at 37C(Jackson et al., 1988).
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Epidemiology Information:
- Outbreak Locations:
- FIRST PUBLISHED REPORT: In the period October 1980-May 1981, 5 young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii pneumonia at 3 different hospitals in Los Angeles, California. Two of the patients died. All 5 patients had laboratory-confirmed previous or current cytomegalovirus (CMV) infection and candidal mucosal infection(Gottlieb et al., 1981). Pneumocystis pneumonia in the United States is almost exclusively limited to severely immunosuppressed patients. The occurrence of pneumocystosis in these 5 previously healthy individuals without a clinically apparent underlying immunodeficiency is unusual. The fact that these patients were all homosexuals suggests an association between some aspect of a homosexual lifestyle or disease acquired through sexual contact and Pneumocystis pneumonia in this population. All 5 patients described in this report had laboratory-confirmed CMV disease or virus shedding within 5 months of the diagnosis of Pneumocystis pneumonia(Gottlieb et al., 1981). All the above observations suggest the possibility of a cellular-immune dysfunction related to a common exposure that predisposes individuals to opportunistic infections such as pneumocystosis and candidiasis. Although the role of CMV infection in the pathogenesis of pneumocystosis remains unknown, the possibility of P. carinii infection must be carefully considered in a differential diagnosis for previously healthy homosexual males with dyspnea and pneumonia(Gottlieb et al., 1981).
- PRISONS: According to a national survey of jails and prisons, compared to the genereal population, rates of human immunodeficiency virus (HIV) infection among incarcerated individuals are 8 to 10 times higher. In the 1980s and 1990s, the HIV and crack cocaine epidemics and high rates of incarceration associated with the war on drugs had a devastating and synergistic impact on the physical and mental health of families in urban neighborhoods in the United States. Within public health, the rapid expansion of the correctional system can also have unintended consequences. Initiating antibiotic treatment for tuberculosis, HIV, or other sexually transmitted diseases without adequate follow-up to ensure completion of treatment can lead to the development of drug resistance, a peril to the community as a whole(Freudenberg et al., 2001). On June 30, 1997, more than 6300 state/federal prison inmates and more than 2800 jail inmates had AIDS. Also, there were more than 2600 state/ federal prison releasees and more than 36 000 jail releasees with AIDS in 1997. Thus, almost 16% of the estimated total of 247 000 persons living with AIDS in the United States in 1997 passed through a correctional facility that year(Hammet et al., 2002).
- INJECTION DRUG USERS: Despite a rigorous seroepidemiological surveillance program, only 31 HIV-1-infected individuals were identified in Kaliningrad in the time period of 1988 to June 1996. The yearly incidence rate from 1988 - 1995 in the region was from 0 to 0.09 per 10 000 calculated for the total population. In July 1996, a rapid increase in monthly new HIV-1 infections was detected, which continued through the following year. Between 1 July 1996 and 30 June 1997, 1335 newly diagnosed HIV-1-infected individuals (plus 141 who were tested anonymously, total cumulative number 1507) were detected in Kaliningrad. This gives a yearly incidence rate of 6.07 per 10 000 in 1996 (an increase of 6744% compared with 1995) and the incidence for the first 6 months of 1997 was 8.79 per 10 000. Most of the infected individuals were young, over 65% were in the 14 to 25-year age-group, and 20% were aged 14 to 18 years. Amongst 1269 infected individuals who were asked about their possible risk factors for HIV infection, the majority (n = 1208) reported injecting drug use. In 47 cases the reported risk factor was sexual contact (homo-/heterosexual) and 14 infected individuals were children born to infected mothers. Individuals were asked about risk factors using a standardized questionnaire; 335 individuals were asked about their transmission risk before testing, and 934 were asked when positive test results were delivered. In addition to the 141 anonymous tests, risk factors could not be determined for 97 individuals. The drug that the majority of the interviewed individuals with the injecting drug use risk factor reported using (> 95%) was a home-made opiate extracted from locally produced or imported poppy stems and heads(Liitsola et al., 1998).
- HEMOPHILIACS: In July l982, three heterosexual hemophilia A patients, who had developed Pneumocystis carinii pneumonia and other opportunistic infections, were reported. Each had in vitro evidence of lymphopenia and two patients who were specifically tested had evidence of T-lymphocyte abnormalities. All three have since died. In the intervening 4 months, four additional heterosexual hemophilia A patients have developed one or more opportunistic infections accompanied by in-vitro evidence of cellular immune deficiency. These additional cases of AIDS among hemophilia A patients share several features with the three previously reported cases. All but one are severe hemophiliacs, requiring large amounts of Factor VIII concentrate. None had experienced prior opportunistic infections. All have been profoundly lymphopenic (1000 lymphocytes/cubic mm) and have had irreversible deficiencies in T-lymphocytes. Clinical improvement of opportunistic infections with medical therapy has been short lived. Two of the five have died. In most instances, these patients have been the first AIDS cases in their cities, states, or regions. They have had no known common medications, occupations, habits, types of pets, or any uniform antecedent history of personal or family illnesses with immunological relevance(MMWR et al., 1982).
- WOMEN IN SOUTHERN US: In 2003, women constituted 28% of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/ AIDS) cases in the United States; approximately 69% of those cases were among non-Hispanic black women. Heterosexual transmission is now the most commonly reported mode of HIV transmission among women. In North Carolina, black women make up a growing proportion of newly reported HIV infections and, in 2003, the HIV-infection rate for black women in North Carolina was 14 times higher than that for white women. Despite this disparity, few epidemiologic studies have examined HIV transmission among black women in the United States, particularly those residing in southern states. In August 2004, the North Carolina Department of Health (NCDOH) invited CDC to assist in an epidemiologic investigation of HIV transmission among black women in North Carolina. This report summarizes the results of that investigation, which indicated that the majority of HIV-positive and HIV-negative sexually active black women in North Carolina reported HIV sexual risk behaviors. These findings underscore the need for enhanced HIV-prevention strategies in this population(MMWR et al., 2005).
- ASIA: The extensive spread of HIV started late in Asia, compared with the rest of the world. The earliest cases of AIDS were reported from Asia in 1984 and 1985, but the potential for widespread epidemics was not appreciated until the more extensive spread of HIV in Cambodia, India, Burma, and Thailand in the early 1990s. Unfortunately, the lessons of devastation from AIDS in Africa and the Caribbean went unheeded in much of Asia, and success stories of disease prevention at the national level in the region remain few. National adult HIV prevalence varies from near 0% in several countries to almost 3% in Cambodia. But a static map cannot show the time evolution of these epidemicsand therein lie major hints about the future of HIV in the region. Temporally, the countries of Asia can be divided into three categories: (1) those where HIV hit early and hard, and where adult HIV prevalence now exceeds 1% eg, Cambodia, Burma, Thailand, and some states in India; (2) those currently in transition, with HIV epidemics growing noticeably in the past 5 years eg, China, Indonesia, Nepal, and Vietnam; and (3) those having very low levels of infection such as: Bangladesh, Laos, the Philippines, and South Korea. Adult HIV prevalence peaked at roughly 15% in Thailand in 1996 and at 33% in Cambodia in 1998. Prevalence is currently falling in both countries, rather than continuing a steady growth. The reason is that they undertook extensive and intensive prevention campaigns with good coverage, which were focused specifically on reducing risk related to sex work in both clients and sex workers. In both countries, condom use between sex workers and clients increased to more than 90%, and the number of men visiting sex workers was halved (from 20% to 10%). This result then raises the issue of what is likely to happen in the countries in transition such as China, Indonesia, and Vietnam. In the absence of extensive prevention programmes to reduce HIV transmission in at-risk populations (clients and sex workers, injecting drug users, and men who have sex with men), they might be expected to see steadily climbing HIV prevalence(Ruxrungtham et al., 2004).
- THAILAND: Thailand experienced its first case of AIDS in 1984. Approximately 800,000 Thais were infected with HIV in 1995 and 1 million Thais became infected by the year 2000. There have been 5 major epidemic waves: among male homosexuals (started 1984-5), intravenous drug users (started 1988), female commercial sex workers (started 1989), male clients (started 1990), and housewives and the newborn (started 1991). Approximately 96 per cent of HIV-1 infected Thais carried recombinant subtype A/E, the rest carried B'. Nine phase I/II HIV-1 vaccine trial protocols have been or are being tested. A phase III trial of gp120 subtype B/E (AIDSVAX, VaxGen) was started in 1999, a total of 2,500 volunteers will be enrolled, and interim analysis is planned for August 2002. Thai investigators are also participating in pre-clinical development of recombinant BCG and DNA vaccines. Multidisciplinary and multi-level approaches, both by the government and private sectors, have had a positive impact on the HIV epidemic as shown by the declining seroprevalence of HIV infection in Thai male conscripts, and of major sexually transmitted diseases in men. Nevertheless, more effort at the grass roots level is needed to ensure further success and sustainability of the control of the HIV epidemic in Thailand(Ruxrungtham and Phanuphak, 2001).
- INDIA: The HIV pandemic is rapidly spreading in India and has infected more than 4 million individuals. Studies have shown a rapid rise in HIV seroprevalence in high-risk groups like commercial sex workers, patients having STDs and IV drug abusers. However, the Indian epidemic is not only restricted to persons with high-risk behaviour, but has also entered the general population. The first HIV positive Indian was reported in 1992 at the Centre. The occurrence of HIV infection increased from nil in 1986 to 19.9% in 2003. The HIV seropositivity was significantly higher (z = 6.79; P < 0.001) in males (6.9%) than in females (3.3%). It was observed that HIV prevalence was highest in the age group of 25 to 29 years in both sexes(Anvikar et al., 2005).
- UGANDA: The timing and scale of HIV prevalence declines in Uganda were distinct. HIV prevalence nationally among pregnant women peaked in 1991 at 21.1% and by 1998 declined to 9.7%, a decline of 54% apparentin both rural and urban settings. By 2000, prevalence had declined further to 6%. In Kampala and other urban sites, where age-specific data were available, HIV declined most in younger age groups, best reflecting recent incidence, with declines of 75% in 15-to 19-year-olds and 60% in 20- to 24-year olds. We expected to see a similar HIV pattern in neighboring countries, but statistically significant HIV declines were absent in similar data in Kenya, Malawi, and Zambia overall or in the 15 to 24 age cohorts. Uganda provides the clearest example that human immunodeficiency virus (HIV) is preventable if populations are mobilized to avoid risk. Despite limited resources, Uganda has shown a 70% decline in HIV prevalence since the early 1990s, linked to a 60% reduction in casual sex. The response in Uganda appears to be distinctively associated with communication about acquired immunodeficiency syndrome (AIDS) through social networks. Despite substantial condom use and promotion of biomedical approaches, other African countries have shown neither similar behavioral responses nor HIV prevalence declines of the same scale. The Ugandan success is equivalent to a vaccine of 80% effectiveness. Its replication will require changes in global HIV/AIDS intervention policies and their evaluation(Stoneburner and Low-Beer, 2004).
- SOUTH AFRICA: South Africa is in the midst of one of the fastest growing HIV epidemics in the world. In the year 2000, an estimated 40% of deaths in adults aged 15-49 were attributable to AIDS, making it the single highest cause of death in South Africa. In the year 2002, there were more people living with HIV in South Africa than in any other country in the world. Simultaneously, South Africa has been the site of growing alarm at the high levels of rape reported from various sources, and the issues of sexual violence and violence against women in general have gained considerable political importance and visibility. Recent initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, are making resources to address HIV/AIDS available on an unprecedented scale, and donor enthusiasm for introducing antiretroviral drugs must be met with an equal commitment to strengthening the systems that enable such drugs to be accessible, and which give them broader meaning(Kim et al., 2003).
- ORPHANS: According to a United Nations report published in October 2003, half the new cases of HIV infection that occur across the world each year are among 15-24 year olds. This group, constituting two and a half million people, are the next generation of parents. The situation is particularly catastrophic in sub-Saharan Africa where widespread poverty and underdevelopment already undermine childrens health and well being. It is estimated that 10 million people in this region between the ages of 15 and 24, and up to 45% of pregnant women, are infected. With this recognition of the high prevalence of HIV in pregnant women in parts of sub-Saharan Africa, major efforts have been directed at developing and implementing interventions to prevent mother-to-child transmission. These efforts have been largely successful: antiretroviral medication, caesarean section, and locally appropriate feeding practice can now reduce transmission from 40% to below 10%.4 In sub-Saharan Africa these interventions are unfortunately not widely available, but nonetheless, it is still the minority of children who are infected. Orphaning is increasing in sub-Saharan Africa as rates of adult mortality have started to accelerate. However, by far the largest group of vulnerable young children are those living with an HIV infected mother. In sub-Saharan Africa approximately 70% of infected mothers survive for at least the first five years of their childrens lives, and this number will increase with the rollout of antiretroviral medication. It is known that the early years of life are crucial for a childs development, and it is likely that maternal HIV disrupts the rearing environment, thereby putting these children at risk(Stein et al., 2005).
- LATIN AMERICA: By May 2000, 306 536 AIDS cases were reported to the Pan American Health Organization (PAHO/WHO) from countries in Latin America and Caribbean (LAC). Only 1.8% were paediatric cases and 1.5% were perinatal. Since 1993 the male-to-female ratio has significantly decreased from 3.3 to 2.3 in 1999, but the sex rate varies from 1.5 in the Caribbean to 3.5 in the Andean region. There are important differences in the mode of transmission in the different sub-regions. Whereas 42% of total cumulative AIDS cases were transmitted by homosexual or bisexual contact in the Andean region, only 9 and 11% reported this mode of transmission in the Caribbean and Central America. Transmission by injecting drug use varies widely, with higher rates reported in Brazil (19%) and Southern Cone countries (up to 33.4%) and much lower numbers in other subregions. The dominant mode of transmission varies from country to country, but it is mainly through homosexual and bisexual contacts and injecting drug use in most of Mexico, South America and the Andean countries. In Central America and Brazil, heterosexual transmission plays an increasing and important role for HIV dissemination. Brazil being the largest country and most populated country presents a very different state of epidemics among its population. In the Caribbean basin, the main mode of HIV transmission is by heterosexual sex(Calleja et al., 2002).
- Transmission Information:
- From:
Human, Human immunodeficiency virus , To:
Human, Human immunodeficiency virus
Mechanism: GENERAL: The variability observed among and within routes of HIV exposure depends partly on the viral dose and also on whether the virus is transmitted directly into the blood or onto a mucous membrane. In addition, these differences are influenced by a variety of host factors, including both factors common to all routes of exposure and those unique to sexual transmission(Royce et al., 1997). Host susceptibility depends on viral entry into cells through CD4 and chemokine surface receptors. These cells include CD4 T lymphocytes, T Langerhans cells, and other macrophages. In macaques, virus appears in dendritic cells of the vaginal lamina propria soon after vaginal inoculation with simian immunodeficiency virus (SIV). HIV-receptive cells have been found in the lamina propria of oral, cervicovaginal, foreskin, urethral, and rectal epithelia in other primate models(Royce et al., 1997). A late stage of infection is a strong predictor of infectiousness according to both epidemiologic and biologic data. When the index partner has more advanced HIV infection indicated by symptoms of HIV disease, a diagnosis of the acquired immunodeficiency syndrome (AIDS), CD4 counts below 200 cells per cubic millimeter, or p24 antigenemia sexual partners are at a much higher risk of acquiring infection (relative-risk range, 6.1 to 17.6). Host infectiousness is likely to increase as a function of the concentration of virus in the genital tract. Higher viral loads in the blood have been associated with the transmission of HIV to sexual partners of people with transfusion-acquired infections. Data on viral concentration in blood and semen generally support the epidemiologic inferences about the importance of the stage of infection in the transmission of HIV(Royce et al., 1997). The presence of reproductive tract infections is strongly associated with susceptibility to HIV, even after adjustment for sexual behavior. The prevalence of genital ulcer disease (chancroid, syphilis, or herpes) is associated with an increased relative risk of HIV infection, ranging from 1.5 to 7.0 in both men and women(Royce et al., 1997). The properties of HIV itself may also influence transmission. Subtype E, the most common subtype in Thailand, is reported to have a greater tropism for Langerhans cells than subtype B. This tropism may contribute to the rapid epidemic spread of HIV through Thailand and the high percontact transmission rate observed there. High concentrations of HIV in semen specimens from sub-Saharan Africa may reflect differences among HIV clades in the ability to replicate in vivo. There appear to be phenotypic differences between isolates in blood and those in semen. Nonsyncytia-inducing viral isolates that are macrophagetropic are found early in HIV disease and may be better adapted to spreading than lymphocytotropic organisms. Particular viral-envelope geneticsequences are required for vaginal transmission of chimeric simian-human immunodeficiency viruses. Genotypic differences in the viral envelope in blood as compared with genital specimens have been reported in women. In addition, other phenotypic differences between HIV harvested from blood plasma and that harvested from genital secretions may affect the efficiency of transmission. Antiretroviral drug resistance, for example, appears in cell-free and cell-associated virus in the blood and semen at different times(Royce et al., 1997).
- From:
Human, Human immunodeficiency virus , To:
Human, Human immunodeficiency virus
Mechanism: SEXUAL: Transmission through sexual contact accounts for 75 to 85 percent of the nearly 28 million infections with the human immunodeficiency virus (HIV) that have occurred so far(Royce et al., 1997). On a world-wide scale, the vast majority of new infections are acquired through heterosexual contact. The likelihood of transmission from male to female has been estimated to be as high as 8-fold more likely that from female to male, although the biological basis for this is not fully understood(Hansasuta and Rowland-Jones, 2001). VAGINAL (MALE to FEMALE): Using logistic regression analysis, including gender and controlling for condom use, frequency of intercourse, anal sex, partner's CD4+ cell count and clinical stage, sexually transmitted diseases, genital infections, and contraceptive use, we found that the efficiency of male-to-female transmission was 2.3 (95% confidence interval = 1.1-4.8) times greater than that of female-to-male transmission(Nicolosi et al., 1994). The risk per episode of receptive vaginal exposure is estimated at 0.1% to 0.2%(CDC, 1998). VAGINAL (FEMALE to MALE): The overall probability of female-to-male HIV-1 transmission per sex act was 0.0063, several times higher than has been estimated from studies of HIV-1 serodiscordant couples. Infectivity for uncircumcised men was significantly higher than for circumcised men (0.0128 vs. 0.0051;P=0.04 ). Overall transmission probability estimates ranged from 0.0038 to 0.0122 when different HIV-1 prevalences among sex partners were assumed, and a ~23-fold greater infectivity was seen for uncircumcised men compared with circumcised men, across all HIV-1 prevalences(Baeten et al., 2005). ANAL: U.S. survey and other data suggest that, in terms of absolute numbers, approximately seven times more women than homosexual men engage in unprotected receptive anal intercourse. Research among higher risk subpopulations, including bisexual men, injecting drug users, female sex workers, inner-city adolescents, and serodiscordant heterosexual couples, indicates that persons particularly at risk of being infected by or transmitting HIV are also more likely to practice anal sex. Considering this finding, along with the much greater efficiency for HIV infection as well as lower rates of condom usage, a significant proportion of heterosexual transmission in some populations is due to anal intercourse(Halperin, 1999). The major behavioral risk factors in the transmission of the Human Immunodeficiency Virus (HIV) between homosexual/bisexual men include receptive anogenital exposure to infected ejaculate and a large number of sexual partners. Among the 129 men with infected study partners, only the number of receptive anal exposures, truncated at 100, was significantly associated with infection at the 0.05 level. The risk of infection per outside partner was estimated to be 0.075 (+/- 0.018) when only participants with uninfected primary partners were included in the analysis, but 0.095(+/- 0.018) when the full cohort was used(DeGruttola et al., 1989). The risk for HIV transmission per episode of receptive penile-anal sexual exposure is estimated at 0.1% to 3%(CDC, 1998). ORAL: Although casual contact with saliva remains an insignificant factor, oral sexual contact may now be of increasing importance in the transmission of HIV. Oral sex may be less efficient than needle-sharing or anal intercourse for the transmission of HIV, but its increased use by men who have sex with men (MSM) and its prominence in the sexual activity of crack smokers may increase its contribution to HIV transmission. Based on several different models, the per-partner infectivity of receptive oral intercourse (ROI) was about 1% (range, 0.85% - 2.3%), where per-partner refers to the risk with a given partner, uncontrolled for activity level, and should be distinguished from the risk of a single sex act (per-contact risk). In comparison, the per-partner infectivity of anal receptive intercourse was about 10% (range, 4.2% - 12%). In a modeling study that incorporated the stage of infection, it was estimated that oral sex acts imposed a transmission risk that was one-sixth that of anal sex acts. In an assessment of per-contact risk for transmission associated with four types of homosexual contact, Vittinghoff et al. estimated that the risk for unprotected receptive anal sex (0.24%; 95% CI, 0.05 - 0.43) was eight times the risk for unprotected receptive oral sex (0.03%; 95% CI, 0.01 - 0.18)(Rothenberg et al., 1998). ROLE OF VIRAL LOAD: The mean serum HIV-1 RNA level was significantly higher among HIV-1-positive subjects whose partners seroconverted than among those whose partners did not seroconvert (90,254 copies per milliliter vs. 38,029 copies per milliliter, P=0.01). There were no instances of transmission among the 51 subjects with serum HIV-1 RNA levels of less than 1500 copies per milliliter; there was a significant dose-response relation of increased transmission with increasing viral load. In multivariate analyses of log-transformed HIV-1 RNA levels, each log increment in the viral load was associated with a rate ratio of 2.45 for seroconversion(Quinn et al., 2002).
- From:
Human, Human immunodeficiency virus , To:
Human, Human immunodeficiency virus
Mechanism: INJECTION DRUG USE: The AIDS epidemic among injection drug users (IDUs) in the United States was first recognized in 1981. Through case surveillance conducted by the Centers for Disease Control and Prevention (CDC), IDUs with opportunistic infections (OIs) and poor immune response were identified and classified as cases of what was then known as gay-related immune disease. These early cases among IDUs had significant epidemiologic impact. They provided the first evidence that the disease was not restricted to men who have sex with men (MSM), and raised the possibility that the causal agent was blood-borne and likely transmitted through the reuse of contaminated injection equipment(Metzger and Navaline, 2003). The risk for HIV transmission per episode of intravenous needle or syringe exposure is estimated at 0.67%(CDC, 1998).
- From:
Human, Human immunodeficiency virus , To:
Human, Human immunodeficiency virus
Mechanism: BREASTFEEDING: In this trial, the estimated rate of breast milk HIV-1 transmission was 16.2% during the first 2 years of life. Given an HIV-1 infection rate of 36.7% in the breastfeeding arm, breast milk transmission accounted for 44% of all infant infections among those exposed to breast milk. Because more than one quarter of women in the formula arm admitted to noncompliance with feeding modality, our estimated breast milk transmission rate is an underestimate. Because cumulative HIV-1 infection rates in the 2 arms were significantly different as early as 6 weeks of life, our data suggest that substantial transmission occurs early during breastfeeding. By 6 months, an estimated 75% of all breast milk transmission had occurred, despite ongoing exposure for an average of 1 additional year(Nduati et al., 2000).
- From:
Human, Human immunodeficiency virus , To:
Human, Human immunodeficiency virus
Mechanism: BLOOD TRANSFUSION: The general availability of a safe blood supply is of considerable concern to the bood-banking community, public health practitioners, clinicians, and the public. Approximately 1.5 percent of the U.S. population receives transfusions of blood products donated by an estimated 4 million persons each year, and the transfusion rate in persons over 65 years of age is three to four times this figure. The screening of blood donors for HIV-1 antibodies that now takes place has greatly reduced but not eliminated the risk of HIV-1 transmission by transfusion. Our estimate of this risk was 0.003 percent(Cohen et al., 1989). The risk of viral infection associated with blood transfusion is lower than ever before because of aggressive screening and testing practices. The risks were recalculated based on 2001 repeat donor incidence data collected by the American Red Cross. The calculated risk of HIV infection per 1,000,000 RBC units transfused is 0.82 (1 / 1.2 million units transfused)(Jackson et al., 2003). HIV can be transmitted efficiently through blood transfusions: an estimated 95% of recipients become infected from transfusion of a single unit of infected whole blood(CDC, 1998).
- From:
Human, Human immunodeficiency virus , To:
Human, Human immunodeficiency virus
Mechanism: OCCUPATIONAL: Of 57 healthcare workers with documented occupationally acquired HIV infection, most (86%) were exposed to blood, and most (88%) had percutaneous injuries. The circumstances varied among 51 percutaneous injuries, with the largest proportion (41%) occurring after a procedure, 35% occurring during a procedure, and 20% occurring during disposal of sharp objects. Unexpected circumstances difficult to anticipate during or after procedures accounted for 20% of all injuries. Of 55 known source patients, most (69%) had acquired immunodeficiency syndrome (AIDS) at the time of occupational exposure, but some (11%) had asymptomatic HIV infection. Eight (14%) of the healthcare workers were infected despite receiving postexposure prophylaxis (PEP)(Do et al., 2003). The risk per episode of percutaneous exposure (e.g., a needlestick) to HIV-infected blood is estimated at 0.4% (upper limit of 95% confidence interval [CI] = 0.8%)(CDC, 1998).
- From:
Human, Human immunodeficiency virus , To:
Human, Human immunodeficiency virus
Mechanism: SELF-INOCULATION: We identified seven cases of intentional self-inoculation with HIV-positive material. Of these, six are known to have died, and the median time from HIV diagnosis to death was 71 months. All were white and four were women. Five worked in healthcare settings with access to contaminated sharps; one was a caregiver for family members with AIDS, and one had access to HIV-contaminated material through an HIV-positive friend. Five out of the seven had been diagnosed with depression before the inoculation event, and most hadother diagnosed psychiatric disorders based on medical record review or patient self-report(Kellerman et al., 2004).
- From:
Human, Human immunodeficiency virus , To:
Human, Human immunodeficiency virus
Mechanism: ARTIFICIAL INSEMINATION: A 35-year-old female health worker with some occupational risk for acquisition of HIV-1 infection had an acute infectious mononucleosis-like syndrome. She was in hospital for several days. 3 weeks later, she was positive for HIV-1 antibodies. She initially denied any risk factors in her private life, but later disclosed that 3 weeks before her illness she had unsuccessfully undergone artificial insemination with fresh sperm. Upon notification of the patient's illness, the gynaecologist concerned retested the donor, who had meanwhile seroconverted. Viral RNA from the recipient's serum (collected 12 weeks after the date of insemination) was reverse transcribed and the V3 region was amplified by nested PCR. Nucleotide sequence determination of the amplification product revealed 100% identity with viral sequences from the donor on the nucleotide level which was amplified from the DNA of peripheral blood mononuclear cells(Matz et al., 1998).
- Environmental Reservoir:
- Humans:
- Description: AIDS is unique in human history in its rapid spread, its extent and the depth of its impact. Since the first AIDS case was diagnosed in 1981, the world has struggled to come to grips with its extraordinary dimensions. Now, more than 20 years later, 20 million people are dead and 37.8 million people (range: 34.6 - 42.3 million) worldwide are living with HIV. And still, AIDS expands relentlessly, destroying peoples lives and in many cases seriously damaging the fabric of societies(UNAIDS et al., 2004). Two viruses cause AIDS in humans, HIV-1 and HIV-2. In the light of recent confirmation that SIVcpz is the progenitor of HIV-1, it is not surprising that HIV-1 can readily be transmitted to common chimpanzees (Pan troglodytes). HIV-1 infection of the other species of great apes (gorilla, bonobo, orangutan) has not been reported, though HIV-1 infection of gibbons has been reported. In concordance with the generalization that the primate lentiviruses do not cause disease in their natural hosts, chimpanzees infected with viruses of the HIV-1/SIVcpz group do not develop significant CD4+ T-cell loss or AIDS(Joag, 2000). SIVsmm is the progenitor of HIV-2 and SIVmac, which appear to have arisen due to cross-species transmission to humans and macaques, respectively. SIVmac infection in macaque monkeys is a well-characterized model of AIDS(Joag, 2000). Both HIV-1 and HIV-2 are of zoonotic origin. The closest simian relatives of HIV-1 and HIV-2 have been found in the common chimpanzee (Pan troglodytes) and the sooty mangabey (Cercocebus atys), respectively, and phylogenetic evidence indicates that lentiviruses from these species (SIVcpz and SIVsm, respectively) have been transmitted to humans on at least eight occasions. The current HIV-1 pandemic provides compelling evidence for the rapidity, stealth, and clinical impact that can be associated with even a single primate lentiviral zoonotic transmission event. We document for the first time that humans are exposed to a plethora of primate lentiviruses through hunting and handling of bushmeat in Cameroon, a country at the center of HIV-1 groups M, N, and O endemicity that is home to a diverse set of SIV-infected nonhuman primates. To what extent wild monkey populations in other parts of Africa are also infected with diverse SIVs is unknown. A complete and accurate assessment of all SIV-infected nonhuman primate species is needed, as well as a determination of the virus lineage(s) present in each species. Studies are also needed to determine whether zoonotic transmissions of SIVs from primates other than chimpanzees and mangabeys have already occurred and what clinical outcomes were associated with these infections. Results from these studies will yield critical insights into the circumstances and factors that govern SIV cross-species transmission and thus allow determination of human zoonotic risk for acquiring these viruses(Peeters et al., 2002).
- Survival: IN HUMAN: The median survival [of HIV-1 infected patients] from seroconversion to death was 9.8 years, which is considerably longer than has been expected in African populations. This is also comparable to survival times of around 10 years (ranging from 8.3 to approximately 13 years) reported by cohort studies in industrialized countries prior to the widespread use of antiretroviral therapy(Morgan et al., 2002). IN SYRINGE: At 4C, 50% of all syringes contained viable HIV-1 at 42 days storage, the longest storage duration tested. At room temperature (20C), the last day that syringes with 2uL of infected blood were positive was Day 21, and viable HIV-1 was recovered from 8% of syringes. Above room temperature (27, 32, and 37C), the likelihood of encountering syringes with viable HIV-1 when periods of storage exceeded 1 week decreased to less than 1%. The temperature at which drug injectors are likely to store their used syringes will vary according to climate, season, and circumstances faced by the injector. The survival of HIV-1 in contaminated syringes varied over a range of temperatures, and this may be a factor influencing the syringe-borne transmission of HIV-1(Abdala et al., 2000). LAB STORAGE: A recently developed assay for measuring infectious HIV-1 particles was used to determine the stability of the virus under various storage conditions as well as the effect of commonly used disinfectants. At the optimum pH of 7.1 the half life of the virus ranged from approx. twenty-four hours at 37C to no significant loss over 6 months at -75C. Drying the virus on a glass surface or freezing caused a 5-12 fold and 4-5 fold decrease of activity, respectively. The dried preparations, however, were about as stable as when stored in a buffered solution. A solution of iodine and detergent (2% Jodopax) was the only disinfectant examined which removed all detectable HIV-1 activity. Isopropanol and ethanol were more potent than acetone; however, all three solvents left some viable particles after a 30 min treatment with 70% solutions(Tjotta and Hungnes, 1991).
- Intentional Releases:
- Intentional Release Information:
- Description: Transmission of human immunodeficiency virus type 1 (HIV-1) from a male accused of rape and deliberate transmission of HIV-1 was investigated by sequencing of the HIV-1 pol and gag genes from virus obtained from the male and from the female victim. We found that the male and female shared two distinct genetic variants of HIV-1. In pl7gag the major variant had an unusual, out-of frame deletion of 3 nucleotides which the minor variant lacked. These results indicated that the male had transmitted more than one infectious unit to the female. From this study we concluded that it was highly likely that the HIV-1 strains carried by the male and the female were closely epidemiologically linked(Albert et al., 1994).
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Diagnostic Tests Information
- Immunoassay Test:
- Enzygnost HIV Integral II (Dade Behring Marburg) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Enzygnost HIV Integral II cost $2.07 to $2.70 per test in 2004 and was rated as being less easy and less suitable for use in small laboratories by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 1.2%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 2.3%](World Health Organization, 2003).
- Antigen:
- Antibody:
- Genedia HIV Ag-Ab ELISA (Green Cross Life Science) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Enzygnost HIV Integral II cost $0.35 to $0.55 per test in 2004 and was rated as being less easy and less suitable for use in small laboratories by the World Health Organization(World Health Organization, 2003).
- False Positive: 0.3% [95% CI = 0% - 1.9%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 2.3%](World Health Organization, 2003).
- Antigen:
- Antibody:
- Genscreen Plus HIV Ag/Ab (Bio-Rad Laboratories) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Genscreen Plus HIV Ag-Ab cost $0.62 to $0.68 per test in 2004 and was rated as being less easy and less suitable for use in small laboratories by the World Health Organization(World Health Organization, 2003).
- False Positive: 1.7% [95% CI = 0.6% - 3.9%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 2.3%](World Health Organization, 2003).
- Antigen:
- Antibody:
- Murex HIV Ag/Ab Combination (Abbott/Murex) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Murex HIV Ag/Ab Combination cost $0.80 to $1.20 per test in 2004 and was rated as being less easy and less suitable for use in small laboratories by the World Health Organization(World Health Organization, 2003).
- False Positive: 0.7% [95% CI = 0.1% - 2.4%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 2.3%](World Health Organization, 2003).
- Antigen:
- Antibody:
- Vironostika HIV Uni-Form II Ag/Ab (bioMerieux) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Vironostika HIV Uni-Form II Ag/Ab cost $1.48 to $1.95 per test in 2004 and was rated as being less easy and less suitable for use in small laboratories by the World Health Organization(World Health Organization, 2003).
- False Positive: 1% [95% CI = 0.2% - 2.9%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 2.3%](World Health Organization, 2003).
- Antigen:
- Antibody:
- Vironostika Uni-Form II plus O (Organon Teknika) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Vironostika Uni-Form II plus O cost $1.50 per test in 1997 and was rated as being less easy and less suitable for use in small laboratories by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 0.3%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 0.4%](World Health Organization, 2003).
- Enzygnost Anti-HIV-1/2 Plus (Behringwerke) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Enzygnost Anti-HIV-1/2 Plus cost $1.00 per test in 1995 and was rated as being less easy and less suitable for use in small laboratories by the World Health Organization(World Health Organization, 2003).
- False Positive: 0.3% [95% CI = 0% - 0.9%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 0.4%](World Health Organization, 2003).
- IMx HIV-1 / HIV-2 3rd generation Plus (Abbott) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: IMx HIV-1 / HIV-2 3rd generation Plus cost $3.00 per test in 1995 and was rated as being very easy and suitable for use in small laboratories by the World Health Organization(World Health Organization, 2003).
- False Positive: 2.1% [95% CI = 0% - 3.6%](World Health Organization, 2003).
- False Negative: 0.4% [95% CI = 0% - 1.1%](World Health Organization, 2003).
- HIV EIA (Labsystems) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: The HIV EIA cost $0.60 per test in 1995 and was rated as being less easy and less suitable for use in small laboratories by the World Health Organization(World Health Organization, 2003).
- False Positive: 0.6% [95% CI = 0% - 1.4%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 0.4%](World Health Organization, 2003).
- UBI HIV-1/2 EIA (United Biomedical) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: UBI cost $1.00 per test in 1994 and was rated as being less easy and less suitable for use in small laboratories by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 0.3%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 0.4%](World Health Organization, 2003).
- Recombigen HIV-1 and/or HIV-2 EIA (Trinity Biotech) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Recombigen cost $1.70 per test in 1993 and was rated as being less easy and less suitable for use in small laboratories by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 1.4%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 1.4%](World Health Organization, 2003).
- Western Blot (Diagnostic Kit Insert - Western Blotting):
- Time to Perform: unknown
- Description: The Enzyme-Linked lmmunosorbent Blot Technique (Western Blot), has been used to detect antibodies to Human lmmunodeficiency Virus Type 1 (HIV-l), which has been recognized as the etiological agent of the Acquired lmmunodeficiencv Syndrome (AIDS). The combination of electrophoretic separation of complex mixtures of antigens with the highly sensitive immunoblotting technique has been useful in characterizing the antigenic profile of HIV-1 and describing the immune response to this virus in exposed or infected persons. The Cambridge Biotech HIV-1 Western Blot Kit, when used as directed in this insert, will detect antibodies to HIV-1 when present in human serum, plasma, or urine. The position of bands on the nitrocellulose strips allows this antibody reactivity to be associated with specific viral antigens(Diagnostic Kit Insert - Western Blotting).
- HIVAB HIV-1/HIV-2 (rDNA) EIA (Diagnostic Kit Insert - HIVAB EIA):
- Time to Perform: 1-hour-to-1-day
- Description: The HIVAB HIV-1/HIV-2 (rDNA) EIA was developed to allow the simultaneous detection of IgG and IgM antibodies to HIV-1 and HIV-2 and to identify potentially infectious units of donated blood and plasma. It has been established that repeatedly reactive units of blood and plasma should be eliminated from the blood supply. In the HIVAB HIV-1/HIV-2 (rDNA) EIA, human serum, plasma, or cadaveric serum is diluted in a specimen diluent and incubated with a polystyrene bead coated with Recombinant HIV-1 env and gag and HIV-2 env proteins. Specific antibody present in the sample reacts with the antigens on the coated bead. After removal of the unbound aterials and washing of the bead, specific immunoglobulins remaining bound to the solid phase are detected by incubating the bead-antigen-antibody complex with a solution containing HIV-1 gag and env together with HIV-2 env Recombinant proteins labeled with horseradish peroxidase (HRPO)(Diagnostic Kit Insert - HIVAB EIA).
- False Positive: Specificity based on an assumed zero prevalence of antibody to HIV-1 and/or HIV-2 in random donors (17037 out of 17054) is estimated to be 99.90%* with a 95% confidence interval: 99.83-99.94% (Table II). *In these calculations, one sample of the eighteen total repeatedly reactive specimens was confirmed by Western Blot and has been excluded(Diagnostic Kit Insert - HIVAB EIA).
- False Negative: HIV-1 sensitivity was equivalent to a previously licensed test in a population of 352 AIDS patients with known antibodies (352 out of 352 detected for an estimated sensitivity of 100% with a 95% confidence interval: 99.15 - 100%, Table III). Similarly the HIV-1 sensitivity was equivalent to a previously licensed test for 1042 known positive samples from other groups with ARC, High Risk or clinical status unknown (1042 out of 1042 detected for an estimated sensitivity of 100% with a 95% confidence interval: 99.71 - 100%,(Diagnostic Kit Insert - HIVAB EIA).
- Antigen:
-
HIV-1 env (rDNA)
-
HIV-1 gag (rDNA)
-
HIV-2 env (rDNA)
- Antibody:
- OraQuick (MMWR, 2002):
- Time to Perform: minutes-to-1-hour
- Description: On November 7, 2002, the Food and Drug Administration announced approval of the OraQuick Rapid HIV-1 Antibody Test (OraSure Technologies, Inc., Bethlehem, Pennsylvania) for use by trained personnel as a point-of-care test to aid in the diagnosis of infection with human immunodeficiency virus type 1 (HIV-1). OraQuick is a simple, rapid test that can detect antibodies to HIV in fingerstick whole blood specimens and provide results in <20 minutes. The test has been categorized as moderate complexity under the Clinical Laboratory Improvement Amendments of 1988(MMWR, 2002). OraQuick was reactive with OMT and sera from 97 of 101 HIV-infected subjects and 0 of 100 subjects who were uninfected (sensitivity and specificity, 96 and 100%, respectively). Concordance between serum and oral mucosal transudate (OMT) testing and interobserver concordance (kappa = 1.0, P < 0.001) were 100%(O'Connell et al., 2003). OraQuick HIV-1/2 Rapid HIV-1/2 (OraSure Technologies Inc) cost $4.00-12.00 in 2004 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0.4% [95% CI = 1.5% - 0.1%](MMWR, 2002). WITH HAART 0%(O'Connell et al., 2003).
- False Negative: 0% [95% CI = 0.3% - 0%](MMWR, 2002). WITH HAART 4%(O'Connell et al., 2003).
- Antigen:
- Antibody:
- Serodia-HIV (Fujirebio) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: Serodia-HIV (Fujirebio) cost $1.10 in 1988 and was rated as being easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 3.1% [95% CI = 1% - 6.6%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 2.4%](World Health Organization, 2003).
- PATH HIV Dipstick (PATH) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: PATH HIV Dipstick (PATH) cost less than $1.50 in 1991 and was rated as being easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 1.8% [95% CI = 0.9% - 2.9%](World Health Organization, 2003).
- False Negative: 0.5% [95% CI = 0% - 2.7%](World Health Organization, 2003).
- SUDS Murex HIV-1 Ab test (Murex Corporation) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: SUDS Murex HIV-1 Ab test (Murex Corporation) cost $4.50 in 1991 and was rated as being very easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 24.9% [95% CI = 19.1% - 30.7%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 1.5%](World Health Organization, 2003).
- Serodia-HIV-1/2 (Fujirebio) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: Serodia-HIV-1/2 (Fujirebio) cost $2.80 in 1993 and was rated as being less easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 1.5%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 1.5%](World Health Organization, 2003).
- SPAN COMBAIDS VISUAL (Span Diagnostics) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: SPAN COMBAIDS VISUAL (Span Diagnostics.) cost $0.40 in 1993 and was rated as being easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 1.7%](World Health Organization, 2003).
- False Negative: 3.5% [95% CI = 0.5% - 6.5%](World Health Organization, 2003).
- CAPILLUS HIV-1/HIV-2 (Trinity Biotech) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: CAPILLUS HIV-1/HIV-2 (Trinity Biotech) cost $2.20 in 1994 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 1.2% [95% CI = 0% - 2.4%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 0.4%](World Health Organization, 2003).
- Antigen:
- Immunocomb II BiSpot HIV 1 and 2 (PBS Orgenics) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: Immunocomb II BiSpot HIV 1 and 2 (PBS Orgenics) cost $1.70 in 1994 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0.3% [95% CI = 0% - 0.9%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 0.4%](World Health Organization, 2003).
- Antigen:
- SPAN COMBAIDS VISUAL (Span Diagnostics) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: SPAN COMBAIDS VISUAL (Span Diagnostics) cost $0.50 in 1994 and was rated as being easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 12% [95% CI = 8.5% - 15.5%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 0.4%](World Health Organization, 2003).
- Antigen:
-
Recombinant protein
-
Synthetic peptides
- HIV TRI-DOT (J. Mitra and Co) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: HIV TRI-DOT (J. Mitra and Co) cost $2.00 in 1996 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0.3% [95% CI = 0% - 0.9%](World Health Organization, 2003).
- False Negative: 0.4% [95% CI = 0% - 1.1%](World Health Organization, 2003).
- AccuSpot HIV-1 and 2 (Specialty BioSystems) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: AccuSpot HIV-1 and 2 (Specialty BioSystems) cost $2.50 in 1995 and was rated as being very easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 13.7% [95% CI = 9.9% - 17.5%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 0.4%](World Health Organization, 2003).
- BIONOR HIV-1 and 2 (Bionor) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: BIONOR HIV-1 and 2 (Bionor) cost $2.50 in 1995 and was rated as being very easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 1.2% [95% CI = 0% - 2.4%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 0.4%](World Health Organization, 2003).
- SEROCARD HIV (Trinity Biotech) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: SEROCARD HIV cost $4.00 in 1994 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 2.1% [95% CI = 0.9% - 3.6%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 0.4%](World Health Organization, 2003).
- HIV 1 and 2 DoubleCheck (Orgenics) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: HIV 1 and 2 DoubleCheck cost $2.00 in 1996 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0.6% [95% CI = 0% - 1.4%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 0.4%](World Health Organization, 2003).
- EasiDot HIV/EasiSpot HIV (Nubenco Diagnostics) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: EasiDot HIV/EasiSpot HIV was rated as being very easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 28.7% [95% CI = 23.8% - 33.6%](World Health Organization, 2003).
- False Negative: 4.7% [95% CI = 2.1% - 7.3%](World Health Organization, 2003).
- InstantCHEKTM-HIV 1+2 (EY Laboratories) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: InstantCHEKTM-HIV 1+2 cost $1.00 in 2003 and was rated as being easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 2.4% [95% CI = 1% - 4.8%](World Health Organization, 2003).
- False Negative: 0.6% [95% CI = 0% - 3.5%](World Health Organization, 2003).
- GENIE II HIV-1/HIV-2 (Bio-Rad) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: GENIE II HIV-1/HIV-2 cost $2.55 in 2003 and was rated as being easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0.3% [95% CI = 0% - 1.9%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 2.3%](World Health Organization, 2003).
- Efoora HIV Rapid (Efoora Inc) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: Efoora HIV Rapid cost $0.75-$2.60 in 2003 and was rated as being very easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 1.1% [95% CI = 0.7% - 4.4%](World Health Organization, 2003).
- False Negative: 3.8% [95% CI = 1.4% - 8.1%](World Health Organization, 2003).
- Efoora HIV Rapid (Efoora Inc) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: Efoora HIV Rapid cost $0.75-$2.60 in 2003 and was rated as being very easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 1.1% [95% CI = 0.7% - 4.4%](World Health Organization, 2003).
- False Negative: 3.8% [95% CI = 1.4% - 8.1%](World Health Organization, 2003).
- SD Bioline HIV 1/2 3.0 (Standard Diagnostics) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: SD Bioline HIV 1/2 3.0 cost $1.10 in 2003 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0.7% [95% CI = 0.1% - 2.4%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 2.3%](World Health Organization, 2003).
- Hema Strip(R) HIV 1/2 (Chembio Diagnostics) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: Hema Strip(R) HIV 1/2 cost $1.85-$2.50 in 2003 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 1.2%](World Health Organization, 2003).
- False Negative: 1.9% [95% CI = 0.4% - 5.5%](World Health Organization, 2003).
- HIV 1/2 STAT-PAK (Chembio Diagnostics) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: HIV 1/2 STAT-PAK cost $0.75-$1.25 in 2003 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 1.2%](World Health Organization, 2003).
- False Negative: 2.4% [95% CI = 0.7% - 6.4%](World Health Organization, 2003).
- HIV (1+2) Antibody (Colloidal Gold) (KHB Shanghai Kehua Bioengineering) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: HIV (1+2) Antibody (Colloidal Gold) cost $1.50 in 2003 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 1.2%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 2.3%](World Health Organization, 2003).
- GENEDIA(R) HIV 1/2 Rapid 3.0 (Green Cross Life Science Corp) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: GENEDIA(R) HIV 1/2 Rapid 3.0 cost $0.93-$1.15 in 2003 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0.3% [95% CI = 0% - 1.9%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 2.3%](World Health Organization, 2003).
- DoubleCheckGoldTM HIV 1 and 2 (Orgenics) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: DoubleCheckGoldTM HIV 1 and 2 cost $0.65-$0.70 in 2003 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: Lot A: 4.4% [95% CI = 2.4% - 7.4%] Lot B: 5.4% [95% CI = 3.1% - 8.6%](World Health Organization, 2003).
- False Negative: Lot A: 0.6% [95% CI = 0% - 3.5%] Lot B: 0% [95% CI = 0% - 2.3%](World Health Organization, 2003).
- Ancoscreen (Ancos) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: Ancoscreen (Ancos) cost $10.80-$21.50 in 1989 and was rated as being less easy and less suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 9.6% [95% CI = 4.5% - 17.4%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 2.2%](World Health Organization, 2003).
- IFA anti-HIV-1 (Waldheim Pharmazeutika) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: IFA anti-HIV-1 cost $5.60 in 1991 and was rated as being less easy and less suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 1.7%](World Health Organization, 2003).
- False Negative: 1.1% [95% CI = 0.2% - 3.1%](World Health Organization, 2003).
- New Lav-Blot-I (Sanofi Diagnostics Pasteur) (World Health Organization, 2003):
- Time to Perform: minutes-to-1-hour
- Description: New Lav-Blot-I cost $11.60 in 1991 and was rated as being easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 3.2%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 1.9%](World Health Organization, 2003).
- HIV-1 Western Blot Kit (Open Tray Procedure) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: HIV-1 Western Blot Kit cost $17.70 in 1993 and was rated as being less easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 1.3%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 1.5%](World Health Organization, 2003).
- IFA anti-HIV-2 (Waldheim Pharmazeutika) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: IFA anti-HIV-2 cost $6.00 in 1991 and was rated as being less easy and less suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 1.8%](World Health Organization, 2003).
- False Negative: 1.3% [95% CI = 0.3% - 6.9%](World Health Organization, 2003).
- INNO-LIA HIV-1/HIV-2 Ab (Innogenetics) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: INNO-LIA HIV-1/HIV-2 Ab cost $18.40 in 1989 and was rated as being less easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 2%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 1.4%](World Health Organization, 2003).
- Speedscreen HIV (British Bio-Technology) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Speedscreen HIV cost $17.00 in 1990 and was rated as being less easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 33.6% [95% CI = 25.9% - 42.1%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 0.6%](World Health Organization, 2003).
- Pepti-Lav 1-2 (Sanofi Diagnostics Pasteur) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Pepti-Lav 1-2 cost $21.50 in 1990 and was rated as being less easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 1.9%](World Health Organization, 2003).
- False Negative: 0.7% [95% CI = 0.1% - 3.6%](World Health Organization, 2003).
- Determine HIV-1/2 (Abbott Laboratories Dainabot) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Determine HIV-1/2 cost $1.20 in 2001 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0.6% [95% CI = 0% - 3.3%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 4.5%](World Health Organization, 2003).
- InstantScreenTM HIV-1/2 (Gen 2) (Gaifar) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: InstantScreen HIV-1/2 (Gen 2) cost $8.00-12.00 in 192.00/'01 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 3%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 10%](World Health Organization, 2003).
- ADVANCED QUALITY Rapid HIV Test (InTec Products) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: ADVANCED QUALITY Rapid HIV Test cost $0.80-$1.20 in 2001 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 2.1%](World Health Organization, 2003).
- False Negative: 1.2% [95% CI = 0% - 6.8%](World Health Organization, 2003).
- MedMira Rapid HIV Test (MedMira Laboratories) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: MedMira Rapid HIV Test cost $3.00 in 2000 and was rated as being easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 2.4% [95% CI = 0.4% - 5.9%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 4.5%](World Health Organization, 2003).
- First Response HIV-1/HIV-2 WB (PMC Medical) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: First Response HIV-1/HIV-2 WB cost $1.15 in 2001 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 1.2% [95% CI = 0.1% - 4.2%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 4.5%](World Health Organization, 2003).
- CAPILLUS HIV-1/HIV-2 (Trinity Biotech) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: CAPILLUS HIV-1/HIV-2 cost $2.20 in 2001 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 2.1%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 4.5%](World Health Organization, 2003).
- Uni-Gold HIV (Trinity Biotech) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Uni-Gold HIV cost $2.34 in 2001 and was rated as being very easy and very suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 2.1%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 4.5%](World Health Organization, 2003).
- SMLX Technologies Diagnostic test (SMLX Technologies) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: SMLX Technologies Diagnostic test was rated as being easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 25.2% [95% CI = 18% - 33%](World Health Organization, 2003).
- False Negative: 37.3% [95% CI = 26% - 49%](World Health Organization, 2003).
- OraScreen HIV Rapid Test (Beacon Diagnostics) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: OraScreen HIV Rapid Test was rated as being easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 1.4% [95% CI = 0% - 5%](World Health Organization, 2003).
- False Negative: 44% [95% CI = 32% - 56%](World Health Organization, 2003).
- SalivaxTM-HIV (ImmunoScience) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: SalivaxTM-HIV was rated as being easy and suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 4% [95% CI = 1% - 9%](World Health Organization, 2003).
- False Negative: 20.6% [95% CI = 11% - 33%](World Health Organization, 2003).
- Wellcozyme HIV 1+2 GACELISA (Murex Biotech) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Wellcozyme HIV 1+2 GACELISA was rated as being less easy and less suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 1% [95% CI = 0% - 5%](World Health Organization, 2003).
- False Negative: 0% [95% CI = 0% - 4.8%](World Health Organization, 2003).
- Calypte HIV-1 Urine EIA, Fc (Calypte Biomedical) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Calypte HIV-1 Urine EIA, Fc cost $3.00-$4.25 in 2002 and was rated as being easy and less suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 0% [95% CI = 0% - 1.8%](World Health Organization, 2003).
- False Negative: 2.2% [95% CI = 0.3% - 7.6%](World Health Organization, 2003).
- Calypte HIV-1 Urine EIA (Recombinant) (Calypte Biomedical) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Calypte HIV-1 Urine EIA (Recombinant) cost $3.00-$4.25 in 2002 and was rated as being easy and less suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: 1.4% [95% CI = 0.3% - 4.2%](World Health Organization, 2003).
- False Negative: 1.1% [95% CI = 0% - 5.8%](World Health Organization, 2003).
- Cambridge Biotech HIV-1 Urine Western Blot Kit (CalypteTM Biomedical) (World Health Organization, 2003):
- Time to Perform: 1-hour-to-1-day
- Description: Cambridge Biotech HIV-1 Urine Western Blot Kit cost $26.00 in 2002 and was rated as being easy and less suitable for small laboratory use by the World Health Organization(World Health Organization, 2003).
- False Positive: NA(World Health Organization, 2003).
- False Negative: 1.1% [95% CI = 0% - 5.8%](World Health Organization, 2003).
- Nucleic Acid Detection Test:
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