Molecular diagnosis of HIV-1 infections: Current state of the art

Abstract

In the management of HIV infections, laboratorians or clinical microbiologists determine whether a patient is infected with HIV, evaluate the status of the HIV infection, and monitor antiretroviral therapy. Theoretically, an HIV infection can be diagnosed and monitored by any of five possible ways: (1) direct microscopic examination such as visualization of an HIV virion by electronic microscopy, (2) cultivation and identification of HIV by suspension lymphocyte culture, (3) detection of HIV viral antigens, (4) measurement of HIV-specific immune responses, and (5) detection and quantification of HIV-specific nucleic acids [1, 2]. Practically speaking, the diagnosis and monitoring of HIV infection is done by serologic and molecular methods. Molecular methods were first used by Ou et al. from the US Centers for Disease Control and Prevention in 1988 to directly amplify HIV-1 specific nucleic acids from peripheral blood mononuclear cells of HIV-1 seropositive individuals [3]. In this sentinel article, the authors concluded that the method may therefore be used to complement or replace virus isolation as a routine means of determining HIV-1 infection [3]. This has certainly proven to be correct.