The subject says it all. A normal antivirus has to intercept all file accesses, scan the files and then optionally deny access to the file (possibly even displaying a prompt
In the recent versions of windows (at least XP onwards) there is the concept 'filters' which can be viewed using MS Filter Manager, (fltmc.exe from a command prompt)
This provides a low level I/O hook that AV programs can access and automatically register to be passed all I/O requests to the file system. It is a kit you can get the drivers for an develop your own filters for.
http://www.microsoft.com/whdc/driver/filterdrv/default.mspx is a starting place to get in depth info.