Abstract

PIP: It is well accepted that HIV is the cause of AIDS and that the virus is distributed widely throughout the world. Being able to diagnose infection with HIV through laboratory tests has done much to facilitate the early recognition of the severity and extent of the AIDS pandemic. Many laboratory techniques exist to detect infection with HIV-1 and HIV-2. In recent years, however, African countries have found it difficult to implement such diagnostic tests because the tests have been either ill-suited or too expensive for the developing country setting. This paper describes many of the HIV laboratory diagnostic techniques currently used in both diagnostic and research settings. The review of techniques is, however, neither all-inclusive nor globally applicable, but intended to be simply a view of available techniques from the African perspective. The opening general section on the detection of HIV-1 and HIV-2 is followed by discussion of screening tests, rapid tests, and confirmatory tests to detect HIV antibodies. Techniques to detect virus include viral isolation, the detection of viral antigen, and PCR. HIV testing algorithms are discussed. The authors stress in closing the importance of the effective laboratory diagnosis of HIV in the prevention and control of HIV/AIDS. Laboratory personnel must be trained, cost-effective laboratory techniques made available for the African setting, and test systems chosen which are best adapted to the prevailing epidemiologic, socioeconomic, and cultural contexts. These latter systems often will differ from the types of diagnostic tests and testing algorithms used in more developed countries.