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Chapter 34 : Diagnostic Molecular Virology: Current Practice and Future Trends
Molecular methods are now firmly established as new diagnostic gold standards for most of the clinically important viruses. Molecular methods have changed the face of clinical virology and created new opportunities for laboratories to impact diagnosis and management of patients with viral infections. This chapter discusses the thoughts and impressions on the current practice and future trends in diagnostic molecular virology. Real-time PCR methods have largely replaced conventional, end-point PCR methods in clinical laboratories, with the attendant benefits of speed, broad dynamic range and increased precision for target quantitation, and reduced contamination. Multiplex, real-time amplification methods are limited to three to four different targets by the small number of available fluorescent reporter dyes. These new uses for hepatitis C virus (HCV) viral load measurements provide motivation for patients to complete therapy and permit the individualization of therapy duration. There has also been significant progress in the development of specifically targeted antiviral therapy for hepatitis C, such as NS5 polymerase and NS3/4 protease inhibitors. Phylogenetic genotyping has a more limited role in the clinical management of patients with chronic hepatitis B than it does in patients with chronic hepatitis C .