Progress in diagnosis of opportunistic infections in HIV/AIDS.

The impact of HIV/AIDS is different in developed and developing countries including India. Limited access to health care facilities, lack of infrastructure for diagnostic set up and cost of anti retroviral therapy are some of the reasons. Early accurate diagnosis of opportunistic infections (OIs), the common presenting symptom of the patients, is the key for success of effective management. This review attempts an overview of few of the important OIs with which majority of Indian patients present in the clinics. Emphasis has been on conventional method of diagnostic approach, which is possible in most of the diagnostic laboratory set up in India. Awareness of the disease and maintenance of high index of clinical suspicion are required. An integrated approach to patient management with active interaction between clinicians and microbiologists would be highly beneficial. Introduction of routine in vitro antimicrobial testing system especially for Candida sp, Cryptococcus sp and Mycobacterium sp, is also important, in order to obtain a baseline data on the susceptibility pattern, which not only have therapeutic relevance, but also can predict in advance, any shift in these patterns in the Indian population. Administrative support for the skill development of personnel, facility for data preservation and telemedicine can extend the diagnostic expertise to the remote areas, without affecting the patients mobility.