The Core Retrovirus Laboratory of the Washington University ACTU is currently a state-of-the-art facility for performing HIV diagnostic testing. The scope of operations includes lymphocyte co-cultivation for HIV, ELISA testing for p24 antigen, ELISA and western blot for HIV antibodies, and PCR for HIV DNA. Techniques for HIV antiviral susceptibility testing and RNA PCR are also available. Competence in p24 antigen detection and HIV co-cultivation have been demonstrated in the ACTG quality control program. Electronic communications with Frontier Science Technology Research Foundation (FSTRF) and the Washington University clinical facility are fully operational and are used for electronic transport of data. The Retrovirus Laboratory Management Program (RLMP) is fully operational and is used for specimen tracking and freezer inventories. Use of semi-automated equipment and instrument interfaces to the computer system allow high specimen throughput, and along with the RLMP have made possible prompt and efficient responses to all requests for p24 batch testing, with electronic export of complete data in the proper format. These systems could be adapted to allow the laboratory to receive and process specimens from other ACTUs, with considerable economies resulting from increased testing volume. Performance of 200 p24 antigen assays and 40-50 HIV cultures per week is feasible, and could be accomplished with considerably less than proportional increase in laboratory personnel. In addition to the laboratory's strong record in ACTU-related activities, a high level of expertise exists in other areas of HIV virology. The laboratory currently is capable of performing PCR for HIV DNA and RNA, quantitative plasma and cell cultures, antiviral susceptibility testing and monocyte cultures. The laboratory is involved in several research projects in which these techniques are used and the technical experience can be translated for use with ACTG protocols when the need arises. The laboratory directors are experienced virologists and both are involved in ACTG activities at the committee level. All other laboratory personnel are proficient in both technical procedures and in operating the relevant electronic information systems.
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