Content

Objectives

Reading Assignment

Introduction

• Identify which subtype of human immunodeficiency virus type 1 (HIV-1) is most prevalent in the United States, Europe, and Australia.

Pages 476-494

HIV Transmission

• List the three major routes of HIV transmission.
• Identify scenarios that represent the highest risk of HIV transmission for health care workers.

Characteristics of HIV

• Identify the enzyme that transcribes viral RNA into DNA.
• List the three main structural genes in the genome of HIV.
• Specify which genetic mutation is resistant to HIV infection.

Immunologic Manifestations

• Identify the antibodies first detected in the host’s serum approximately six weeks after infection.
• Discuss how HIV escapes the immune mechanisms of an infected host.

Clinical Symptoms of HIV Infection

• List opportunistic illness indicative of acquired immunodeficiency syndrome (AIDS).
• Discuss factors that may influence the rate of HIV infection progression in children.
• Classify a patient’s HIV stage based on their CD4 T-cell count.

Treatment and Prevention

• Match the antiretroviral drug with its mechanism of action.

Screening and Diagnosis

• Discuss why conventional immunoassays are the cornerstone of screening procedures for HIV.
• Identify possible causes for false-negative results in HIV antibody immunoassays.
• Discuss rapid tests for HIV antibodies.
• Interpret patient laboratory testing results for HIV using the Western blot method.
• Interpret the patient sample that is reactive on the HIV-1 antibody/HIV-2 antibody/p24 antigen test, negative on the HIV-1/HIV-2 antibody test, and reactive on the nucleic acid test (NAT).

Disease Monitoring

• Discuss laboratory markers routinely used to monitor patients for disease progression and to guide treatment after an HIV diagnosis is established.
• Specify the gold standard for enumerating CD4 T-cells.
• Identify which tests are used for viral load determination in individuals with HIV.
• Recognize the differences between quantitative PCR (qPCR) and bDNA.
• Identify mutations detected by genotype resistance assays.

Testing of Infants Younger Than 18 Months

• Identify recommended testing for detecting HIV infection in infants with known prenatal or perinatal exposure to HIV.