Chapter 8 – Laboratory Detection of Human Retroviral Infection

This chapter reviews the methods and limitations of assays to detect evidence of HIV exposure, and provides an approach to the rational use and interpretation of these tests. To interpret past literature, an historical context is also provided. The armamentarium of HIV and HTLV detection systems has continued to grow rapidly. Testing alternatives continue to move from the research bench to the clinical laboratory. The judicious choice of these tools depends upon an increased understanding of the dynamics of retroviral infection, critical head-to-head comparison testing, and cost-benefit decision analyses. Further development and evaluation are warranted for direct HIV-detection methods as well as other immunologic tests of HIV exposure and serologic detection and confirmation of HTLV infection. The context within which any test is used is of critical importance to its interpretation. No test, per se, should be the basis for diagnosis on its own, but rather, a test is merely an aid in correct diagnosis. The practitioner must use test results in the context of a clinical picture to reach an accurate diagnosis.