Abstract
An HIV-1 diagnostic laboratory was established in the Academic Medical Center (AMC) of the University of Amsterdam after the discovery of human immunodeficiency virus (HIV) as the cause of the acquired immunodeficiency syndrome (AIDS). The first AIDS patients were diagnosed here in 1981 and since 1983 we have tested the samples of 50992 patients using a variety of assays that greatly improved over the years. We will describe some of the basic results from this diagnostic laboratory and then focus on the spin-off in terms of the development of novel virus assays to detect super-infections and ultra-sensitive assays to measure the intracellular HIV-1 RNA load. We also review several original research findings in the field of HIV-1 virology that stem from initial observations made in the diagnostic unit. This includes the study of genetic defects in the HIV-1 genome and time trends of the replication fitness over 30 years of viral evolution, but also the description of novel HIV-1 variants in difficult-to-diagnose clinical specimen.
Highlights
The acquired immunodeficiency syndrome (AIDS) was recognized by the Centers for Disease Control (Atlanta, USA) in 1981 [1]
This review focuses on the human immunodeficiency virus (HIV)-1 epidemic in the Netherlands and the diagnostics and research performed at the Academic Medical Center (AMC) hospital of the University of Amsterdam
We described drug-dependent HIV-1 variants that will rapidly disappear in an epidemic upon transmission in the absence of the drug [39]
Summary
The acquired immunodeficiency syndrome (AIDS) was recognized by the Centers for Disease Control (Atlanta, USA) in 1981 [1]. Data from more recent years (>2009) indicate that sequences with more than 2 (PR) or 5 (RT) key mutations are observed less frequently, probably due to the development of Subtype B has always been the most prevalent HIV-1 subtype that circulated in the Netherlands [40], most likely imported through drug users from the USA to initiate the epidemic [41]. The Amsterdam patient under study had a low pVL of less than 1000 copies/ml for 2 years after seroconversion [60], which is observed in less than 1% of the individuals in the ACS cohort This may suggest that the patient was infected with a poorly replicating virus. One study reported no seroreversions in 80 patients tested [104] and another study found 1 out of 84 patients to have seroreverted [105]
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