Update on the laboratory diagnosis and monitoring of HIV infection

In China, the estimated number of HIV infected cases is approaching one million. Although public education has been initiated for awareness and behavioral modification for this devastating infection, better diagnostic methods are needed to identify infected persons and manage infection. Simple and more accurate diagnostic tools have become available, particularly for early detection and to monitor treatment in those who receive anti-retroviral treatment. In this short review, we summarize some of the common and new methodologies that can be used in clinical laboratories, in the field, or in private laboratories. These range from simple antibody tests to more sophistical methods that are used to monitor disease progression and identify drug resistance. These tools can assist physicians, medical practitioners, and laboratory personnel to select suitable diagnostic tools for the diagnosis, blood screening, monitoring of disease progression, and for detection of drug resistance to anti-retroviral therapies.

HIV-1蛋白酶和逆转录酶抗药基因变异检测方法的建立及临床应用

目的 应用现有DNA序列分析技术对人类免疫缺陷病毒 1型 (HIV 1)的蛋白酶 (PR)和逆转录酶 (RT)基因进行简便、快速、准确的序列分析 ,在临床上为HIV 1患者治疗方案的确定提供可靠依据。方法 从HIV 1感染者血清中提取RNA ,用套式逆转录 聚合酶链反应 (RT PCR)扩增HIV 1的PR和RT基因片段 ,并对此片段进行核苷酸序列分析。结果 本方法对血清中HIV 1RNA含量约 2 0 0 0拷贝 ml以上的样品都能有效扩增。在序列分析时背景干扰少 ,对 2 5 %左右的混合序列均能准确反映。通过对临床治疗病人进行动态序列分析观察 ,发现在药物治疗过程中 ,病人血浆中HIV 1RNA含量变化与PR和RT基因抗药性变异具有很大相关性。结论 PR和RT基因序列分析方法能够及时、准确地反映HIV 1患者在抗病毒药物治疗过程中病毒的变异情况。该方法的建立能在临床上能为不同患者治疗方案的确定提供直接。