DIAGNOSIS OF HIV INFECTION

BY
THULASIRAM

 ELISA
WESTERN BLOT
DIRECT DETECTION TESTS

ELISA
standard blood screening test for HIV infection
sensitivity of >99.5%
generally scored as positive(highly reactive), negative(non-reactive), or
indeterminate(partially reactive)
False positive EIA tests

- antibodies to class II antigens(may be seen following

pregnancy, blood transfusion, or transplantation)
- autoantibodies
- hepatic disease
- recent influenza vaccination
- acute viral infections

Hence, the test results to confirmed with a more sensitive specific assay such
as the Western Blot

WESTERN BLOT
based on the fact that multiple HIV antigens of different, wellcharacterised molecular weights elicit the production of specific
antibodies
These antigens can be separated on the basis of molecular weights,
and antibodies to each component can be detected as discrete bands
on the Western Blot.
Criteria established by the U.S. Food and Drug Administration(FDA)
for a positive Western Blot a result is considered positive if
antibodies exist to two of the three HIV proteins : p24, gp41,
gp120/160
absence of p31 should increase the suspicion f a false positive result
of EIA Additional confirmation with an RNA-based test for HIV and/or
a followup Western Blot

 Indeterminate Western Blot cross-reacting antibodies; most

common- p24, p55
in the process of mounting a classic
antibody response
Western Blot should be repeated in 1 month
or use other direct detection tests
Western Blot is a poor screening test among individuals with
negative EIA or PCR for HIV, 20-30% may show one or more bands
on western blot usually faint bands and represent cross
reactivity confirmed by the direct detection assays.

DIRECT DETECTION
TESTS
P24 antigen capture assay
Revrese transciptase PCR( RT-PCR ; Amplicor)
Branched DNA(bDNA ; VERSANT)
Nucleic acid sequence based amplification (NASBA ;
NucliSens)
Hiv RNA by TNA
These tests are useful for the prognosis of HIV infected patients
Used for assessing the response of patients on ART.

LABARATORY
MONITORING OF
CD4+ T COUNTS
1.As the immunodefeciency is associated with
CD4+ T cells , they are the most reliable short
term indicator of disease progression
2.Normal CD4 count is 600-1200 cells /mm3
3.Hence if a patient presents with CD4 counts
less than 500 we can start the prophylactic
therapy against the infections that may occur

THANK YOU