Journal of Clinical Virology 21 (2001) 187 – 196 Diagnosis of HIV infection and laboratory monitoring of its therapy Gu ¨ lden Yılmaz * Istanbul Uniersity, Istanbul Faculty of Medicine, Department of Microbiology and Clinical Microbiology, Diision of Virology and Immunology, Istanbul, Turkey Abstract Background: Serological diagnosis of human immunodeficiency virus (HIV) infection became available in 1985, with the rapid increase in sensitivity and specificity of enzyme-linked immunosorbent assays (ELISAs) and the supplement tests. Molecular tests for detection of HIV in the diagnosis of HIV infection in special settings and monitoring of HIV-1 infection followed this. Objectie and study design: In this review it is intended to give a brief overview of the diagnosis and monitoring of HIV infection. Results and conclusion: Serological methods and molecular methods for the detection and quantitation of HIV are discussed. © 2001 Elsevier Science B.V. All rights reserved. Keywords: Human immunodeficiency virus (HIV); HIV RNA; Proviral DNA; HIV diagnosis www.elsevier.com/locate/jcv 1. Introduction More than 35 million people are infected by human immunodeficiency virus (HIV). As the number of HIV infected people and recent ad- vances in treatment strategies continues to in- crease, laboratory evaluation and monitoring of patients with HIV infection has become more important. Today the laboratory has three main responsibilities for HIV infection: (1) early and sensitive detection of HIV infection should be established for the maintenance of safe blood supply, treatment of HIV infection and the pre- vention of perinatal transmission; (2) viral load should be detected for the laboratory monitoring of HIV infected people; and (3) drug susceptibility testing. In this paper it is intended to present a brief overview of the structure, replication and clinical findings followed by several methods available for the detection of HIV infection, their usage in different clinical settings, methods for quantifica- tion of HIV and their application for monitoring HIV infection. 2. Structure, replication of HIV and clinical findings in HIV infection Human immunodeficiency virus type 1 and type 2 (HIV-1 and HIV-2) are retroviruses. HIV-1 is * Tel.: +90-2126311878/2126351186; fax: +90- 2126351186. E-mail address: guldenyilmaz@superonline.com, ercuyil- maz@superonline.com (G. Yılmaz). 1386-6532/01/$ - see front matter © 2001 Elsevier Science B.V. All rights reserved. PII:S1386-6532(01)00165-2