Past, present and future molecular diagnosis and characterization of human immunodeficiency virus infections

Figures & data

Table 1 Current molecular methods for laboratory diagnosis and characterization of HIV infections

Method	Applicability^a	Turnaround time	Main devices (manufacturer)	Applications	Comments
DNA/RNA qualitative assays	B	1–2 days	APTIMA HIV-1 RNA Qualitative Assay or Procleix HIV-1/HCV Assay (Gen-Probe)	Blood donor screening and aid in acute or primary HIV infection diagnosis	For blood donor screening in pooled specimens; test of choice for HIV infections in newborns and infants
RNA viral load testing	A	1–2 days	COBAS AmpliPrep/TaqMan HIV-1 (Roche); VERSANT HIV-1 RNA (Siemens); NucliSens HIV-1 RNA QT (bioMerieux) RealTime m2000 HIV-1 (Abbott Molecular)	ART monitoring	To guide HAART initiation and monitor the treatment efficacy in conjunction with CD4 counting
Genotypic drug resistance testing	A	1–3 days	TruGene HIV-1 Genotyping (Siemens); ViroSeq HIV-1 Genotyping (Abbott Molecular); HIV PRT GeneChip assay (Affymetrix); HIV RT Line Probe Assay (Innogenetics)	Antiretroviral drug resistance determination	Indirect determination by detecting drug resistance-related HIV gene mutations; may miss low level mutations
Phenotypic drug resistance testing	B	3–6 weeks	AntiVirogram assay (VIRCO Lab; PhenoSense HIV, Trofile (MonoGram Biosciences); SensiTrop II HIV (Pathway Diagnostics)	Antiretroviral drug resistance determination	Direct determination by measuring HIV ability to grow in presence of drugs; time consuming and expensive
Molecular POC testing	C	1–4 h	IsoAmp HIV-1 Assay (BioHelix); ExaVir Load Assay (Cavidi); Liat HIV Quant Assay (IQuum); SAMBA system (Diagnostics for the Real World)	POC diagnosis and monitoring POC	Still in research and development; include HIV RNA detection and quantification
Host polymorphism testing	D	1–3 days	None	Determine host susceptibility to HIV infection	To determine HIV infection susceptibility and monitoring treatment efficacy and side effects
Host response and transcriptome testing	D	1–3 days	Human Genome U133 Array Strip (Affymetrix)	Assess disease progression and outcome; monitor ART	To determine HIV infection susceptibility and monitoring treatment efficacy and side effects