title: [Laboratory diagnosis of HIV infection, viral tropism and resistance to antiretrovirals].
abstract: The accurate diagnosis of HIV infection demands that to consider a positive result, at least three assays with different antigenic base should be used, one of them, Western-Blot being mandatory for confirmation. Fourth generation ELISAs shorten the window phase to 13-15 days, as they now include p24 antigen detection. Proviral DNA or Viral RNA detection by molecular methods have proved useful for addressing complex situations in which serology was inconclusive. Viral load (HIV-RNA) is routinely used to follow-up HIV infected patients and is used for treatment initiation decisions. It is also used to monitor viral failure. When this happens, resistance tests are needed to guide treatment changes. Resistance is also used to assess the transmission of drug resistance to newly diagnosed patients. Finally, before using an anti-CCR5 drug, viral tropism needs to be determined. This can be done using genotypic tests, widely available in many HIV labs, or phenotypic tests, only available at certain sites.
authors.affiliation: Servicio de Microbiología, Hospital Universitario San Cecilio, Granada, España. fegarcia@ugr.es
authors.forename: Federico
authors.initials: F
authors.lastname: García
authors.forename: Marta
authors.initials: M
authors.lastname: Álvarez
authors.forename: Carmen
authors.initials: C
authors.lastname: Bernal
authors.forename: Natalia
authors.initials: N
authors.lastname: Chueca
authors.forename: Vicente
authors.initials: V
authors.lastname: Guillot
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods; D000465:Algorithms; D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D000956:Antigens, Viral / Q000097:blood; D015153:Blotting, Western; D004279:DNA, Viral / Q000032:analysis; D024921:Drug Resistance, Multiple, Viral; D004797:Enzyme-Linked Immunosorbent Assay; D005838:Genotype; D006678:HIV / Q000187:drug effects / Q000235:genetics / Q000502:physiology*; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D025202:Molecular Diagnostic Techniques; D010641:Phenotype; D011533:Proviruses / Q000302:isolation & purification; D012367:RNA, Viral / Q000032:analysis / Q000235:genetics; D019562:Viral Load; D056189:Viral Tropism; D014766:Viremia / Q000175:diagnosis / Q000821:virology
chemical_list: D019380:Anti-HIV Agents; D000956:Antigens, Viral; D004279:DNA, Viral; D012367:RNA, Viral