Monitoring of Human Immunodeficiency Virus Infection in Resource-Constrained Countries

The reference standards used to monitor human immunodeficiency virus (HIV) infection are flow cytometric analysis of T lymphocyte subsets to provide the CD4+ T cell count and molecular assays to quantify plasma HIV load. Few laboratories in resource-constrained countries can afford to perform these...

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Bibliographic Details
Published in:Clinical infectious diseases 2003-07, Vol.37 (Supplement-1), p.S25-S35
Main Authors: Crowe, Suzanne, Turnbull, Shannon, Oelrichs, Robert, Dunne, Amanda
Format: Article
Language:English
Subjects:
AIDS
Biomarkers - analysis
Blood
CD4 Lymphocyte Count
Cytometry
Developed countries
Disease Progression
Health Resources - economics
HIV
HIV infections
HIV Infections - economics
HIV Infections - immunology
HIV Infections - pathology
HIV Infections - virology
HIV-1 - physiology
Humans
Lymphocytes
Quality assurance
Quality Control
T lymphocytes
Viral Load
Viruses
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Summary:The reference standards used to monitor human immunodeficiency virus (HIV) infection are flow cytometric analysis of T lymphocyte subsets to provide the CD4+ T cell count and molecular assays to quantify plasma HIV load. Few laboratories in resource-constrained countries can afford to perform these tests. A number of lower-cost assays requiring less expensive equipment may be well-suited to such countries. These include manual CD4 cell assays (Dynal, Coulter, BioRad) and ultrasensitive reverse transcriptase (Cavidi) and p24 (Perkin Elmer Life Sciences) assays to monitor virus load. Quality control and access to quality assurance programs are essential. The total lymphocyte count, although readily available and inexpensive, generally does not correlate as closely with CD4+ T cell counts. Other surrogate markers, such as β2-microglobulin, are not suitable for routine monitoring of HIV infection. This review discusses the above assays and their role in addition to clinical monitoring in resource-constrained countries.
ISSN:1058-4838
1537-6723
1537-6591
DOI:10.1086/375369