Question

Case 1. Monitoring the earliest immune responses to HIV.

A better understanding of the immune responses to HIV during the period between initial mucosal exposure to the virus and the point at which it becomes detectable in the blood would help inform development of strategies to prevent HIV infection. These early responses have been up to now very difficult if not impossible to study in people with HIV. Babies exposed to HIV through vaginal delivery of untreated HIV-positive mothers were recently analysed in detail by researchers during the first few days after viral exposure. The scientists found that HIV disseminates rapidly through the body, with viral RNA present in at least one tissue outside the skin in most babies analysed one day after vagina exposure. Early host responses that supress viral immunity and promote viral replication were observed. Increasing amounts of viral RNA correlated with rising amounts of a host protein that suppresses non-specific antiviral immunity. Also, activation of a cell-signalling pathway correlated with lower levels of antiviral T-cell responses and higher levels of HIV replication. Thus, the window of opportunity to contain or eliminate HIV at its mucosal exposure is more limited than previously thought. Importantly, scientists can apply these new insights to the improved development of microbicides, vaccines and drugs to prevent HIV infection.

1) How would you possibly track very early HIV responses in babies with a biomarker (CD8+T cells) to show that the virus suppresses proinflammatory mediators?

Answer 1

This is possible done by newborn blood sample which shows antibodies against HIV . Antibodies against HIV are present in all new born who get infected from HIV pregnant mother . However it is not seen intially and can be observed after 6 months of newborn.

HIV viral RNA PCR , HIV p24 antigen are most accurate and useful for diagnosis of HIV in infants born to HIV infected mother.  

HIV total nucleic acid ( RNA + proviral DNA ) PCR test on dried blood spot sample and its confirmation with HIV PCR test on another sample is the new accepted method .