Our understanding of HIV disease progression has been greatly enhanced by the ability to quantify plasma viral RNA1. Viral load measurements, undertaken by a variety of commercial assays, have therefore rapidly become central to HIV patient clinical management protocols2. However, data underpinning the utility of such measurements have only been gleaned from large cohort studies and controlled clinical trials. Little information is available on how these expensive assays are utilized in the routine clinical setting. In late 1996, the Regional Virology Laboratory initiated HIV viral load assays for a number of medium-size and small HIV clinics around the West Midlands according to an agreed protocol (2 pre-treatment baseline assays 4 weeks apart; 4± 8 week post initiation or alteration of therapy; 3± 4 monthly monitoring at intervals in treated patients and 6 monthly in untreated patients). We have audited the use of our HIV viral load service since that time and now report our preliminary ® ndings on assays requested from 25 clinics in and around the West Midlands.
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