ABSTRACT
It cannot be understated that infection with human immunodeficiency virus type 1 (HIV-1; HIV infection) has become the defining viral infection of the past three decades, if not of the past century. Although endogenous retrovirus infection per se has contributed to the silent evolution of our human primate ancestors, it was the emergence of HIV-1 as a fatal viral infection with its attendant immunodeficiency that pushed the envelop of medical research to embrace a totally new dimension of laboratory diagnostics and therapeutics. No other contemporary viral infection has furthered our understanding of the important biological relationship between viruses and the immune system to the same degree, as has HIV-1. Importantly, from the perspective of this chapter, HIV-1 has provided an important impetus for introducing the complexities of serological and molecular diagnostics to both the general public and the health care provider, in addition to the laboratory specialist. The introduction of quantitative nucleic acid testing (HIV-1 RNA and to a lesser extent DNA) and drug susceptibility genotyping as routine molecular diagnostics for the clinical management of HIV-1 infection, along with the acceptance of point-of-care HIV-1 diagnostics, has enriched the interactions among the Public Health Service (United States Centers for Disease Control, CDC), the clinical laboratory, and the clinical practice community. Contemporary reviews of the pathogenesis, epidemiology, clinical features, and treatment of HIV-1 infection are available elsewhere (1). This chapter will focus on recent developments in the laboratory diagnosis and management of HIV infection to enhance the optimum use of laboratory resources for these purposes and updates a recent review of the subject (2).
