Human enterovirus 71 (EV-71) is one of the major etiologic causes of hand, foot, and mouth disease (HFMD) among young children worldwide, with fatal instances of neurological complications becoming increasingly common. Global VP1 capsid sequences (n ‫؍‬ 628) sampled over 4 decades were collected and subjected to comprehensive evolutionary analysis using a suite of phylogenetic and population genetic methods. We

Aims-To use the polymerase chain reaction (PCR) to detect Chlamydia pneumoniae and Chlamydia psittaci in sputum samples. Methods-A nested PCR was developed, the first stage of which amplified DNA from both C pneumoniae and C psittaci while the second stage targeted specifically at C pneumoniae, allowing the two species to be differentiated. The primers were designed not to amplify sequences from C trachomatis. A panel of 26 sputum samples from patients with community acquired pneumonia evaluated previously by enzyme linked immunosorbent assay (ELISA), direct immunofluorescence (DIF), and culture was tested blind by PCR. Most of these specimens also had accompanying serial serum samples which were tested for species specific antibodies using microimmunofluorescence (micro-IF). Results-PCR detected C pneumoniae DNA in 10 of the 26 samples and C psittaci DNA in four. There was good concordance between ELISA, DIF, micro-IF and PCR in the C pneumoniae group. Two of the C psittaci identified by PCR were labelled Cpneumoniae by DIF but the PCR results were supported by serology or a history of bird contact. Of the PCR negative group: six were true negative results; two contained C trachomatis. There were four discrepant results. Conclusions-The data suggest that PCR is effective in the detection of C pneumoniae. The sensitivity for C psittaci is inevitably lower due to the strategy taken but specificity seemed to be good. (7 Clin Pathol 1993;46:313-317)

Table of Contents 1. Levels of evidence1.1 Reference2. Introduction3. Auditable targets4. Table summaries4.1 Initial diagnosis4.2 Assessment of ART‐naïve individuals4.3 ART initiation4.4 Initial assessment following commencement of ART4.5 Routine monitoring on ART4.6 References5. Newly diagnosed and transferring HIV‐positive individuals5.1 Initial HIV‐1 diagnosis5.2 Tests to determine whether acquisition of HIV infection is recent5.3 Individuals transferring care from a different HIV healthcare setting5.4 Communication with general practitioners and shared care5.5 Recommendations5.6 References6. Patient history6.1 Initial HIV‐1 diagnosis6.2 Monitoring of ART‐naïve patients6.3 Pre‐ART initiation assessment6.4 Monitoring individuals established on ART6.5 Assessment of adherence6.6 Recommendations6.7 References7. Examination7.1 Recommendations8. Identifying the need for psychological support8.1 References9. Assessment of immune status9.1 CD4 T cell counts9.2 CD4 T cell percentage9.3 References10. HIV viral load10.1 Initial diagnosis/ART naïve10.2 Post ART initiation10.3 Individuals established on ART10.4 Recommendations10.5 References11. Technical aspects of viral load testing11.1 References12. Viral load kinetics during ART and viral load ‘blips’12.1 References13. Proviral DNA load13.1 References14. Resistance testing14.1 Initial HIV‐1 diagnosis14.2 ART‐naïve14.3 Post treatment initiation14.4 ART‐experienced14.5 References15. Subtype determination15.1 Disease progression15.2 Transmission15.3 Performance of molecular diagnostic assays15.4 Response to therapy15.5 Development of drug resistance15.6 References16. Other tests to guide use of specific antiretroviral agents16.1 Tropism testing16.2 HLA B*5701 testing16.3 References17. Therapeutic drug monitoring17.1 Recommendations17.2 References18. Biochemistry testing18.1 Introduction18.2 Liver function18.3 Renal function18.4 Dyslipidaemia in HIV‐infected individuals18.5 Other biomarkers18.6 Bone disease in HIV‐infected patients18.7 References19. Haematology19.1 Haematological assessment and monitoring19.2 Recommendations19.3 References20. Serology20.1 Overview20.2 Hepatitis viruses20.3 Herpes viruses20.4 Measles and rubella20.5 Cytomegalovirus (CMV)20.6 References21. Other microbiological screening21.1 Tuberculosis screening21.2 Toxoplasma serology21.3 Tropical screening21.4 References22. Sexual health screening including anal and cervical cytology22.1 Sexual history taking, counselling and sexually transmitted infection (STI) screening22.2 Cervical and anal cytology22.3 Recommendations22.4 References23. Routine monitoring recommended for specific patient groups23.1 Women23.2 Older age23.3 Injecting drug users23.4 Individuals coinfected with HBV and HCV23.5 Late presenters23.6 References Appendix