The changing epidemiology of HIV/AIDS at a Minnesota hospital: impact of demographic change and viral diversity.

The past decade has seen a dramatic influx of African-born immigrants and refugees into Minnesota. The impact of this on Hennepin County Medical Center (HCMC), a public teaching hospital located in Minneapolis, has been considerable, especially in the management of HIV-infected persons given that approximately 30% of newly diagnosed individuals seen at HCMC in the past 3 years acquired the virus in Africa. An ongoing and permanent alteration in the demographics of HIV/AIDS in this part of the American midwest is clearly occurring, therefore, accompanied by considerable diversification of the viral makeup of the epidemic. The following article describes currently available data on the viral characteristics of the African-born HIV-infected population of Minnesota and highlights the potential impact of this expanding viral diversity on the ability of the clinical laboratory at HCMC to provide the virologic information necessary to manage effectively patients infected with the HIV virus.