What is the role of viral culture in HIV testing?

Answer

This technique is based on the isolation of the virus by cultivation of PBMC in an individual with human immunodeficiency virus (HIV)–1 infection with phytohemagglutinin-stimulated donor PBMCs with interleukin-2.

The main use of viral culture is for diagnosis of HIV-1 infection in infants, but, given its disadvantages (the test is expensive, is labor intensive, has a biohazard potential, and requires 2-3 weeks before a result can be obtained), it has been supplanted by NAATs.^{[48, 49]}

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Incidence of HIV infection by risk group. Courtesy of the CDC; derived from the revised 2006 estimated figures.
Timeline of CD4 T-cell and viral-load changes over time in untreated human immunodeficiency virus (HIV) infection. Courtesy of Wikipedia, based on an original from Pantaleo et al (1993).
Estimated new HIV diagnoses in the United States for the most affected subpopulations in 2014. Courtesy of the CDC (Centers for Disease Control and Prevention. HIV Surveillance Report, 2014; Vol 26. Online at: http://www.cdc.gov/hiv/library/reports/surveillance/. Published November 2015. Accessed Oct 24, 2016.)
Sequence of appearance of laboratory markers for HIV-1 infection. Note that units for vertical axis are not noted because their magnitude differs for RNA, p24 antigen, and antibody. Courtesy of the CDC (Centers for Disease Control and Prevention and Association of Public Health Laboratories. Laboratory Testing for the Diagnosis of HIV Infection: Updated Recommendations. Online at: http://stacks.cdc.gov/view/cdc/23447. Published June 27, 2014. Accessed Oct 24, 2016.)
Recommended laboratory HIV testing algorithm for serum or plasma specimens. Courtesy of the CDC (Centers for Disease Control and Prevention and Association of Public Health Laboratories. Laboratory Testing for the Diagnosis of HIV Infection: Updated Recommendations. Online at: http://stacks.cdc.gov/view/cdc/23447. Published June 27, 2014. Accessed Oct 24, 2016.)
New HIV Diagnoses in the United States for the Most-Affected Subpopulations, 2016. Courtesy of the CDC (Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2010–2015. HIV Surveillance Supplemental Report 2018;23(No. 1). Online at: http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Published March 2018. Accessed Sept 10, 2018.)
Recommended laboratory HIV testing algorithm for serum or plasma specimens. Courtesy of the CDC (Centers for Disease Control and Prevention and Association of Public Health Laboratories. 2018 Quick reference guide: Recommended laboratory HIV testing algorithm for serum or plasma specimens. Online at: https://stacks.cdc.gov/view/cdc/50872. Published January 2018. Accessed Sept 10, 2018.)
Guidance for Reporting Results from the HIV Laboratory Eiagnostic Testing Algorithm for Serum and Plasma Specimens. Courtesy of the CDC (Centers for Disease Control and Prevention and Association of Public Health Laboratories. 2018 Quick reference guide: Recommended laboratory HIV testing algorithm for serum or plasma specimens. Online at: https://stacks.cdc.gov/view/cdc/50872. Published January 2018. Accessed Sept 10, 2018.)

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Author

David J Cennimo, MD, FAAP, FACP, AAHIVS Assistant Professor of Medicine and Pediatrics, Adult and Pediatric Infectious Diseases, Rutgers New Jersey Medical School

David J Cennimo, MD, FAAP, FACP, AAHIVS is a member of the following medical societies: American Academy of HIV Medicine, American Academy of Pediatrics, American College of Physicians, American Medical Association, HIV Medicine Association, Infectious Diseases Society of America, Medical Society of New Jersey, Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Coauthor(s)

Vanessa Soetanto, MD Resident Physician, Department of Internal Medicine and Pediatrics, Rutgers New Jersey Medical School

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America; Fellow of the Royal College of Physicians, London

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Acknowledgements

Nelson Ivan Agudelo Higuita, MD Fellow in Infectious Diseases, Oklahoma University Health Sciences Center

Nelson Ivan Agudelo Higuita, MD is a member of the following medical societies: Infectious Diseases Society of America and Oklahoma State Medical Association

Disclosure: Nothing to disclose. Michelle R Salvaggio, MD, FACP Assistant Professor, Department of Internal Medicine, Section of Infectious Diseases, University of Oklahoma College of Medicine; Medical Director of Infectious Diseases Institute, Director, Clinical Trials Unit, Director, Ryan White Programs, Department of Medicine, University of Oklahoma Health Sciences Center; Attending Physician, Infectious Diseases Consultation Service, Infectious Diseases Institute, OU Medical Center

Michelle R Salvaggio, MD, FACP is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Merck Honoraria Speaking and teaching

What is the role of viral culture in HIV testing?

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