[Virological diagnosis and follow-up of HIV infection]

ABSTRACT

Human immunodeficiency virus [HIV] is a retrovirus infecting approximatively 40 millions people worldwide. HIV is characterized by a great variability with epidemiological, diagnostic and therapeutic implication. This course of infection goes through three stages [acute infection, clinical latency and AIDS] with the evolution of virological markers [anti-HIV antibodies, p24 antigenemia, plasma RNA and prevail DNA]. Direct virological diagnosis is mainly based on molecular tools allowing viral genome detection and amplification with specific primary and nucleic probes, besides p24 antigenic detection, and more rarely culture. Antigenic properties of viral proteins elicit in infected patients antibody synthesis, which is detected using serology [ELISA and Western blot tests]. The follow-up of infected patients is carried out with plasma HIV-1 RNA quantization and phenotypic or genotypic characterization of variant isolated. Virological testes are prescribed according of clinical presentation [screening, acute infection, newborn from HUIV-infected mother]. Most of these virological tools are available in Tunisia, allowing both diagnosis of HIV infection and monitoring of infected individuals. Regarding diagnostic tests indication and interpretation, multidisciplinary concentration is hopeful in order to optimize patient management