Efficiency of the polymerase chain reaction for the detection of human immunodeficiency virus type (HIV-1) DNA in the lymphocytes of infected persons: comparison to antigen-enzyme-linked immunosorbent assay and virus isolation.

Seventy-one human immunodeficiency virus type (HIV-1)-positive patients were investigated by polymerase chain reaction (PCR), virus isolation, and antigen detection for the existence of HIV in blood. The identification of HIV DNA by PCR, using three different pairs of primers, yielded a clearly higher detection rate (86%) than with two primer pairs (75%) and was far more sensitive than virus isolation (45%) and antigen ELISA (14%). The PCR-negative results were clearly correlated to asymptomatic clinical stages. However, there was a limited correlation between the clinical stage of disease and the amount of HIV DNA that could be detected in equal numbers of CD4+ cells from different patients, which might be due to their treatment with azido-thymidine (AZT).

[Dental care of HIV carriers]. / Zahnbehandlung bei HIV-Tragern. Probleme--Massnahmen--Konzepte.

As HIV infections continue to spread worldwide, the number of patients with known or unknown HIV positivity seen in dental practice is increasing. Some of the infected individuals need more frequent dental care than the general population, because HIV infections tend to be associated with specific oral manifestations. HIV-positive individuals have special psychosocial problems attributable both to their disease and to their frequent association with socially discriminated groups. These problems are also reflected in the dentist-patient relationships. Dental care of known HIV-positive individuals is much less hazardous than the treatment of undiagnosed HIV carriers. Building confidence between the dentist and the patient is essential. As HIV transmission is similar to that of hepatitis B, the full battery of hygienic precautions established for preventing hepatitis B should be observed in dental work to prevent HIV infections. Conditions of work in dental offices should meet the hygienic standards needed to preclude the risk of infections both for the dentists and their patients.

Neopterin estimation compared with the ratio of T-cell subpopulations in persons infected with human immunodeficiency virus-1.

We measured neopterin, a biochemical indicator for the activation of cell-mediated immune reactions, in urines from 105 individuals at risk of infection with human immunodeficiency virus-1 (HIV-1), 83 of whom were seropositive for antibody to HIV-1. We compared absolute numbers of T-cell subsets (CD4+ helper/inducer T-cells, CD8+ suppressor/cytotoxic T-cells), and the ratio of CD4+ T-cells to CD8+ T-cells with the urinary neopterin concentrations. Concentrations of neopterin in urine were inversely correlated with absolute numbers of CD4+ T-cells and with CD4+/CD8+ ratios in anti-HIV-1 seropositive subjects but not in those seronegative. Various statistical comparisons of the data further demonstrated that neopterin concentrations showed larger differences between anti-HIV-1 seronegative and seropositive subjects than absolute numbers of CD4+ T-cells or CD4+/CD8+ ratios. These results seem to indicate that neopterin concentrations increase earlier in the course of HIV-1 infection, before effects on T-cell subpopulations are detectable, and may further support the suggestion that neopterin measurement could be of use for monitoring infected subjects or predicting the progression of disease.

Identification of individuals at increased risk for AIDS among clinically asymptomatic homosexuals and abusers of intravenous drugs.

Immunological parameters previously shown to constitute an increased risk for progression towards AIDS have been observed in clinically asymptomatic individuals considered to be at risk for this syndrome. These parameters include severely decreased numbers of T helper cells (count below 400/mm3 blood for CD4+ cells were detected in 7 our of 33 HIV antibody-positive, asymptomatic homosexuals and in 3 out of 29 HIV antibody-positive, asymptomatic drug abusers) and elevated serum IgA and IgM levels (found in 7 to 30 percent of these subjects). Furthermore, up to 60% of risk group members showed a decreased lymphoproliferative response to tetanus toxoid as compared to only 11% of so-called low responders in the simultaneously tested healthy controls. Finally, the capacity to mount an immune response to viral glycoproteins was found to be impaired in individuals at risk for AIDS, as indicated by a low serum level of antibodies to tick-borne meningoencephalitis virus antigen in recently vaccinated subjects.