[Molecular diagnosis of HIV-1 infection: potential roles and applications]

Abstract

Diagnostic tests for HIV-1 infection have allowed to reduce the transmission of this virus by blood transfusions. They have also allowed to offer prophylactic as well as therapeutic measures early in the infection. The laboratory diagnosis of HIV-1 infection relies mainly on serological testings. Seroconversion can be detected earlier than previous assays with the use of purified HIV antigens such as peptides or recombinant proteins. The low sensitivity level of p24 antigen detection can be improved by acid dissociation of immune complexes in serum samples. A promising method, the polymerase chain reaction (PCR) will facilitate the diagnosis of HIV infection for newborns from seropositive mothers. During PCR, a segment of the genome of HIV is amplified a million-fold and products of amplification are detected by specific probes. The status of individuals with indeterminate serology results could be clarified with PCR. It could also potentially allow the prospective follow-up of patients under therapy to detect viral resistance. The usefulness of this powerful technology in clinical medicine still needs to be determined for HIV-1 diagnosis.