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Inicio Enfermedades Infecciosas y Microbiología Clínica Diagnóstico de las infecciones por subtipos no B del VIH-1 y por VIH-2
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Vol. 26. Issue S13.
Programa Externo de Control de Calidad SEIMC. Año 2007
Pages 66-70 (November 2008)
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Vol. 26. Issue S13.
Programa Externo de Control de Calidad SEIMC. Año 2007
Pages 66-70 (November 2008)
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Diagnóstico de las infecciones por subtipos no B del VIH-1 y por VIH-2
Diagnosis of HIV-1 non-B subtypes and HIV-2
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4461
Carlos Toroa,
Corresponding author
carlostororueda@hotmail.com

Correspondencia: Dr. C. Toro. Servicio de Microbiología. Hospital Carlos III. Sinesio Delgado, 10. 28029 Madrid. España.
, Aranzazu Amora, Vicente Sorianob
a Servicio de Microbiología. Hospital Carlos III. Madrid. España
b Servicio de Enfermedades Infecciosas. Hospital Carlos III. Madrid. España
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Resumen

La diversidad genética del virus de la inmunodeficiencia humana (VIH) constituye un reto para su identificación y caracterización microbiológica. A la continua aparición de nuevas variantes se une la diseminación global de tipos, subtipos y formas recombinantes, lo que obliga a conocer la fiabilidad de las pruebas diagnósticas empleadas para reconocer dichas cepas. En esta revisión se analizan los problemas que actualmente plantean los métodos de cribado, diagnóstico y monitorización de las variantes genéticas distintas del VIH-1 subtipo B. También se examina el rendimiento de algunos algoritmos diagnósticos de introducción más reciente, como los propuestos para caracterizar el tropismo viral. Mientras que el comportamiento de las pruebas serológicas y de ácidos nucleicos es excelente para la mayoría de las cepas del VIH, exceptuando las genéticamente más separadas (VIH-1 grupos O, N y VIH-2), el de las herramientas bioinformáticas es más pobre, y principalmente es fiable para el subtipo B del VIH-1. En conclusión, la continua diversidad genética del VIH obliga a estar atento al rendimiento de las pruebas de cribado y es un estímulo constante para el desarrollo de técnicas moleculares que aseguren la detección de todas las infecciones por VIH. La incorporación de los resultados de estudios in vitro y clínicos sobre las variantes distintas del VIH-1 subtipo B permitirá una mejora de las plataformas bioinformáticas.

Palabras clave:
VIH-1 subtipos no B
VIH-2
Diagnóstico sexológico
Carga viral
Abstract

The high genetic diversity of human immunodeficiency virus (HIV) poses a significant challenge to the diagnosis and microbiological characterization of HIV infection.

Because of the continual emergence of new variants and the global spread of HIV groups, subtypes and recombinant forms, accurate diagnostic tools are of prime importance.

The present review analyzes the problems posed by HIV assays for antibody screening, nucleic acid testing and patient monitoring in HIV-1 non-B subtypes, as well as the utility of some recently introduced genetic algorithms, such as those proposed for the characterization of viral tropism. Overall, the reliability of serological and molecular tests for HIV-1 strains is high, except for the more genetically diverse HIV variants (HIV-1 group O, N, and HIV-2). In contrast, genetic algorithms show acceptable accuracy for HIV-1 subtype B, but are less accurate for non-B subtypes.

In conclusion, the ongoing evolution of HIV requires constant monitoring of the performance of screening tests and provides a stimulus to the development of molecular assays to detect all spreading and emerging HIV variants. The availability of both in vitro and clinical data from studies of HIV-1 non-B subtypes will improve the performance of bioinformatics tools.

Key words:
HIV-1 non-B subtypes
HIV-2
Serological diagnosis
Viral load
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Copyright © 2008. Elsevier España S.L.. Todos los derechos reservados
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