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Chapter 56 : Introduction
It is probably not unreasonable to say that the clinical virology laboratory has experienced the greatest amount of change of any clinical pathology laboratory since the last edition of this Manual. The traditional virology laboratory, as found in many larger hospital-based facilities, often no longer exists, having been replaced by molecular diagnostics. Accordingly, the first chapter in this section now covers rapid and molecular diagnostic methods as well as the traditional diagnostic procedures that still pertain. Rarely are culture or antigen detection methods still in regular use. Likewise, the ability to detect low copy numbers of viral nucleic acids, as well as the ability to accurately quantify the amount of virus present based on nucleic acid amplification, has limited the practical application of serologic methods to immune status testing, with a few well-known exceptions. There are many obvious benefits associated with the adoption of molecular diagnostics for viral infections, such as an increase in the diagnostic sensitivity. In addition, these technologies allow for the rapid deployment of tests for newly described viral pathogens. Quantitative methods facilitate diagnosis and allow prognostic application and facilitate patient management. This is not to say that serologic methods have been stagnant. There has been increasing adoption of avidity-based testing for chronic viral infections to facilitate the differentiation of primary infection from reactivation.