OPTIMAL USE OF DIAGNOSTIC LABORATORIES FOR EVALUATION OF PATIENTS WITH THE ACQUIRED IMMUNODEFICIENCY SYNDROME

Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.

OPTIMAL USE OF DIAGNOSTIC LABORATORIES FOR EVALUATION OF PATIENTS WITH THE ACQUIRED IMMUNODEFICIENCY SYNDROME

Infect Dis Ther; 3:401-35 1989. Unique Identifier : AIDSLINE ICDB/90665456
Ng VL; Hadley WK; Dept. of Lab. Medicine, Univ. of California, San Francisco, CA

Abstract: The diagnosis of AIDS depends on laboratory identification of the opportunistic infecting organism(s) as well as on the detection of HIV antibodies, the presence of which are an essential part of an AIDS diagnosis in a patient infected with a less-common opportunistic pathogen. This demand for the services of pathology and microbiology laboratories has increased dramatically since the onset of the AIDS epidemic. The most efficient and cost-effective strategy for using the pathology and microbiology laboratories to evaluate the patient clinically suspected of having AIDS is described. Topics include culture and HIV detection (reverse transcriptase activity assay, detection of HIV p24 antigen, cell fusion detection methods, detection methods for HIV antibodies, enzyme-linked immunosorbent assay methodology [blood supply screening and HIV diagnosis], 'confirmatory' tests [Western blot and indirect immunofluorescence assay], and antigen detection assays), diagnosis of other viral illnesses, bacterial infections (unusual bacterial isolates and mycobacteriosis), diagnosis of fungal infections, diagnosis of parasitic infections (cryptosporidiosis, isosporiasis, Toxoplasma gondii, and Pneumocystis carinii), and nonspecific laboratory tests of questionable utility (general biochemical tests and tests of immune function). The laboratory methods of choice for detection of specific AIDS-associated opportunistic infections are histologic or cytologic microscopy for pneumocystosis, toxoplasmosis, cryptosporidiosis, isosporiasis, strongyloidiasis, cytomegalovirus, progressive multifocal leukoencephalopathy, Kaposi's sarcoma, lymphoma, and PLH/LIP complex; histologic or cytologic microscopy on a specimen of affected tissue or gross inspection by endoscopy or autopsy for candidiasis; histologic or cytologic microscopy, culture, or antigen detection in a specimen of affected tissue or fluid for cryptococcosis, histoplasmosis, coccidioidomycosis, and herpes simplex virus; and culture for tuberculosis, other mycobacteriosis, and other bacterial infections. (143 Refs)

Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/*DIAGNOSIS AIDS Serodiagnosis/*METHODS Diagnosis, Differential Human HIV Antibodies/ANALYSIS HIV Antigens/ANALYSIS HIV-1/*ISOLATION & PURIF HIV-2/*ISOLATION & PURIF Opportunistic Infections/COMPLICATIONS/DIAGNOSIS JOURNAL ARTICLE REVIEW
912130
M91C4110

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