EARLY AND COMPLETE DETECTION OF HIV EXPOSURE

Currently, HIV diagnosis relies on serology. Yet in groups at high ris k for HIV serology is not sufficient because of the window period betw een infection and seroconversion. There is a growing body of reports o n HIV-infected yet seronegative individuals. Some tests have been deve loped to identify exposure to HIV by its effect on the cells of the im mune system that would differentiate following exposure to the foreign antigens. Detection, in vitro, of HIV-specific B and T cells in seron egative, at risk individuals has been reported. In only some of these individuals was an HIV infection confirmed by other methods. These new assays to detect HIV immunity enable us to identify two new groups am ong seronegative, at risk individuals; namely those with immunity to H IV and a detectable HIV infection (silent carriers), and those with im munity and no proof of infection. Both groups have been exposed to MV yet are not being detected by serology. Both might hold information on other forms of HIV immunity, possibly a protective one. Thus there co uld be an important role for other immunological assays in early detec tion of HIV exposure.