Leader

Monitoring patients with HIV disease

Matthew Helbert¹ and Judy Breuer²

¹ Barts and The London NHS Trust, London EC1A 7BE, UK
² Department of Virology, Queen Mary and Westfield College, London E1 2AD, UK

Correspondence to:
Dr Helbert email: mrhelbert@mds.qmw.ac.uk

Accepted October 20, 1999

Introduction

From early in the human immunodeficiency virus (HIV) pandemic it was noted that a long subclinical latent phase preceded the appearance of opportunist infections. The use of immune monitoring to prompt prophylactic agents considerably reduced morbidity caused by opportunist infection¹ in the 1980s. In the past few years, as new antiretroviral treatments emerged but were threatened by resistance, viral monitoring has been used to guide such treatment. Consensus guidelines on laboratory monitoring^2,3 and treatment⁴ in HIV have been published on both sides of the Atlantic. In this article, we discuss the natural history of HIV infections, current immunological and virological tests, and recommendations for monitoring protocols.J Clin Pathol 2000;53:266–272

Natural history of HIV infection

Efficient infection of T helper cells, macrophages, and dendritic cells by HIV requires expression of the CD4 molecule and chemokine receptors. In early infection, HIV is characteristically trophic for the CCR5 chemokine receptor on macrophages and dendritic cells, explaining why the . . . [Full text of this article]

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