MOLECULAR MONITORING OF HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION

Over the past few year, considerable technical effort has been directe d to developing molecular methods that would allow an effective approa ch to the diagnosis of human immunodeficiency virus type 1 (HIV-1) inf ection and its monitoring. Indeed, quantitative molecular techniques h ave opened the way for a new type of direct study of untreated and tre ated HIV-1 infected subjects. The understanding of the immunopathogene sis of HIV-1 infection has increased significantly with the introducti on of advanced virological and molecular methods for accurate quantita tive analysis of HIV-1 activity, powerful methodologies answer (direct ly and in real time) most questions generated by pathogenic research a nd by the novel anti-viral strategies introduced in clinical practice. The data from pilot diagnostic applications of quantitative technique s have clarified important features of the natural history of HIV-1 in fection. Moreover, an increasing amount of data indicate the need for second-level laboratory facilities for the clinical management of infe cted patients; virological aspects and some genetic features of the ho sts concerning HIV-1 co-receptors (all the co-receptors so far identif ied are members of, or related to, the transmembrane, chemokine-recept or family) need to be elucidated for the complete diagnostic evaluatio n of HIV-1-infected subjects.