Ending AIDS and Sharing Health —Marco & Micro-Test's Contribution to Accurate HIV Diagnosis and Treatment
World AIDS Day 2024 is celebrated on December 1, 2024 with the theme of Take the rights path: My health, my right!
Everyone should have access to the health services they need, including HIV prevention, treatment and care services when and where they need them.
How much do you know about HIV/AIDS? Do you know how to protect yourself and others??
Overview of Global HIV Epidemic
As of 2023, the total global deaths caused by HIV/AIDS since the beginning of the epidemic in the early 1980s is estimated to be approximately 40.4 million, according to UNAIDS and WHO data. This staggering figure underscores that HIV remains a major threat to global health, despite significant progress in reducing mortality rates through advances in antiretroviral therapy and prevention strategies.
What is AIDS?
AIDS, also known as Acquired Immunodeficiency Syndrome, is a severe and highly impactful infectious disease caused by the human immunodeficiency virus (HIV). Currently, there is no vaccine for prevention. While it can be treated, it cannot yet be cured.
When a healthy individual becomes infected with HIV and does not receive timely antiretroviral treatment, the virus begins to attack CD4+ T lymphocytes, progressively weakening the immune system. Over time, the body’s defenses are compromised, leaving it vulnerable to life-threatening conditions.
Stages of HIV Progression
Acute Phase (2–4 weeks after infection):Symptoms: Fever, headache, night sweats, nausea, vomiting, diarrhea, sore throat, muscle and joint pain, swollen lymph nodes, and rash.Symptoms are usually mild and resolve within 1–3 weeks.
Asymptomatic Phase (6–8 years, on average):No obvious symptoms, but the virus continues to replicate and damage the immune system.Some individuals may experience shorter latency, with rapid progression to AIDS within months to a year.
AIDS Phase:Severe symptoms such as persistent fever, weight loss, diarrhea, and swollen lymph nodes. Increased risk of life-threatening cancers (e.g., Kaposi’s sarcoma,non-Hodgkin lymphoma). High susceptibility to opportunistic infections.
Common infections include: Pneumocystis jirovecii pneumonia, Tuberculosis, Cytomegalovirus, Herpes simplex and varicella-zoster viruses,Toxoplasmosis, or Fungal infections.These infections can involve multiple organs and systems, compounding health risks.
Transmission of HIV
HIV is primarily transmitted through the exchange of specific body fluids from a person living with HIV. These include:
1. Blood: This is one of the most common routes of transmission, particularly through sharing needles or unsafe medical procedures, including transfusions and organ transplants.
2. Semen and Vaginal Fluids: Unprotected sexual contact (anal or vaginal sex) with an HIV-positive person is a major route of transmission, especially if there are other sexually transmitted infections (STIs) present.
3. Breast Milk: HIV can be transmitted from a mother to her baby during breastfeeding.
4. Pregnancy and Childbirth: HIV can be transmitted from mother to child during pregnancy or childbirth, though the risk can be reduced significantly with proper treatment (e.g., ART).
Who are at higher risk of HIV infection?
Certain groups are at higher risk for HIV infection due to various behaviors, biological factors, and environmental circumstances:
Men Who Have Sex with Men (MSM): High risk due to unprotected anal sex, which has a higher chance of HIV transmission.
People Who Inject Drugs (PWID): Sharing needles or drug equipment greatly increases the risk of HIV transmission.
Sex Workers: Higher exposure to multiple sexual partners and inconsistent condom use increases the risk of HIV.
People with Multiple Sexual Partners:?Unprotected sex with numerous partners increases exposure to HIV.
Adolescent Girls and Young Women:?Particularly vulnerable in regions like sub-Saharan Africa due to biological and socio-economic factors.
People in High-HIV Prevalence Areas: Living in areas with high HIV rates increases the risk of exposure.
People with Other STIs:?Existing STIs, especially those causing sores, increase susceptibility to HIV.
Regular testing, especially for high-risk groups, is crucial to identify undiagnosed HIV cases.
HIV diagnosis plays a critical role in HIV prevention by enabling early detection and allowing individuals to take preventive and treatment measures. Early diagnosis helps reduce the risk of transmission
What to do after high-risk behavior?
If you've engaged in high-risk behavior, such as unprotected sex with someone whose HIV status is unknown or sharing needles, it's crucial to seek medical advice immediately. Post-exposure prophylaxis (PEP) should ideally be started within 2 hours of exposure for maximum effectiveness, though it can still reduce the risk of HIV if taken within 72 hours. PEP consists of a 28-day course of antiretroviral drugs designed to prevent HIV infection. Additionally, you should get tested for HIV and seek counseling for early diagnosis and treatment, which can help reduce the risk of transmission and improve long-term health outcomes.
Prompt action is vital to minimizing the chances of HIV infection
Who should receive HIV test?
HIV infection can only be confirmed through a test. Individuals who should get tested include those who have engaged in high-risk behaviors, such as unprotected sex, sharing needles, injecting drugs, selling blood, or those who may have received unsafe blood transfusions or injections. Pregnant women living in regions with high HIV prevalence should also seek testing and counseling services. It’s important to remember that HIV-positive individuals may not show symptoms and appear healthy before the disease progresses, so you cannot determine someone's HIV status based on their outward appearance. Early testing is essential for early diagnosis and effective treatment
Here are the common types of HIV tests used for diagnosis and monitoring:
HIV Antibody Test: This is one of the most common methods for detecting HIV infection. It typically detects HIV antibodies in the blood about 21 days after exposure to the virus. This test is commonly used as the first step in HIV screening.
HIV Antigen/Antibody Combination Test: This test detects both HIV antibodies and antigens (a protein from the virus). It can detect HIV earlier than the antibody test, usually around 14 days after infection, by identifying the HIV p24 antigen before the body produces antibodies.
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HIV Nucleic Acid Test: This test detects HIV's genetic material (RNA or DNA). It can detect the virus as early as 7 days after exposure, making it the most sensitive test for detecting acute HIV infection. It is commonly used for early screening or to confirm infection when other tests may not be definitive.
HIV Viral Load Test: Once HIV infection is confirmed, this test measures the amount of HIV in the blood. Monitoring viral load is essential for evaluating treatment effectiveness and guiding adjustments in antiretroviral therapy (ART).
CD4 T-Cell Count: CD4 T-cells are a critical part of the immune system and are the main targets of HIV. A CD4 count helps doctors assess the progression of HIV, evaluate immune system health, and determine the need for ART.
HIV Genotype and Resistance Testing: This testing analyzes the genetic makeup of the HIV virus to identify mutations that may cause resistance to ART. It is particularly useful in adjusting treatment plans when resistance is suspected or confirmed.
These tests play a crucial role in diagnosing HIV, monitoring disease progression, and guiding treatment decisions
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Macro & Micro-Test offers overall molecular solutions for HIV diagnosis
1. Antigen/Antibody Combination Test: The HIV antigen/antibody combination test detects both HIV antibodies and HIV antigens, improving the sensitivity and accuracy of HIV infection detection. If the result is positive, confirmatory testing is usually required to definitively diagnose HIV infection
2. Fluorescence PCR-based HIV Nucleic Acid Test: The HIV nucleic acid test, utilizing fluorescence PCR technology, is a highly sensitive and specific method commonly used in clinical diagnostics. It plays a crucial role in the early detection of HIV infection, enabling timely diagnosis before the appearance of antibodies.
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3. Whole Genome Sequencing (WGS): For individuals who have been or may have been exposed to HIV, whole genome sequencing provides a fast and efficient way to obtain the HIV genome and viral sequence data. This information can reveal transmission relationships between individuals. By performing phylogenetic analysis on the viral sequences, researchers can construct HIV transmission networks, understand transmission patterns, accurately identify potential sources of infection, and pinpoint active transmission networks. This targeted approach aids in implementing precise interventions to control the spread of HIV, particularly in high-risk populations
Marco & Micro-Test has developed an advanced combined?product for HIV-1 drug resistance sequencing, leveraging cutting-edge technologies across Sanger sequencing, next-generation sequencing (NGS), and third-generation sequencing platforms. This product integrates multiple amplification methods and library construction?reagents, paired with their self-developed automated library preparation system and analysis software, enabling rapid and accurate HIV-1 virus genotyping and resistance testing. The system provides end-to-end coverage of the sequencing workflow, from library preparation and sequencing to result generation.
Key Features:
Wide Applicability: The product offers two product lines—Resistance/Genotyping + Resistance—designed to meet the needs of various sectors such as disease control monitoring, clinical research, and routine clinical testing.
Broad Primer Coverage:?Genotyping + Resistance Products: Covers 86.5% of the HIV-1 genome (excluding terminal LTR regions), spanning from 628-9038 bp.
Resistance Products: Targets key enzymes—Protease (1-99aa), Reverse Transcriptase (1-355aa), Integrase (1-288aa). Supports the detection of recombinant subtypes and low-frequency resistance mutations (down to 5%).
High Automation: The combination of the automated AIOS100/800 library preparation system?and the Pathogen Analysis Master?reporting system ensures full automation of the library preparation and data analysis process, saving both time and effort.
Convenient and Compatible: The product utilizes a one-step RT-PCR method, with a 2-tube nested amplification process. The enriched products are compatible with both second and third-generation sequencing?methods, providing high flexibility.
Comprehensive Analytical Functions: The software suite supports viral genotyping, genome assembly, mutation detection, and evolutionary tracing analysis. It allows for precise prediction and annotation of drug resistance sites and facilitates HIV sequence tracing across multiple samples, producing molecular network diagrams.
This system is designed to improve the accuracy of HIV diagnosis and treatment planning, enabling clinicians to address both HIV genotyping and resistance mutations effectively.
Drug resistance testing can achieve high sensitivity and specificity by using targeted enrichment amplification.
The results from first, second, and third-generation sequencing methods are highly consistent, with drug resistance mutation detection yielding the same outcomes across these platforms. However, high-throughput sequencing (such as second and third-generation sequencing) has a superior ability to identify low-frequency mutations when compared to Sanger sequencing. These next-generation technologies are particularly advantageous for detecting additional low-frequency mutations that may be missed by more traditional methods. This enhanced sensitivity is crucial for providing a more accurate and comprehensive understanding of HIV resistance profiles, particularly in cases where mutations occur at low levels within a viral population.
References:
1. HIV statistics, globally and by WHO region, 2024.
2. China CDC HIV Prevention and Control Center.
3. HIV Transmission Network Monitoring and Intervention Technical Guidelines (2021 Trial Version).
4. Baidu Health Dictionary.
5. HIV/AIDS Diagnosis and Treatment Standard (WS293-2019), People's Republic of China Health Industry Standard.
6. National HIV Testing Technical Specifications (2020 Edition).
7. China HIV/AIDS Treatment Guidelines (2021 Edition).
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