Virology Rotation (CP-1 and CP-2)
- Dr. Marie Landry
The Clinical Virology Laboratory is a full-service virology laboratory operating 7 days a week that performs rapid detection of viral antigens in clinical samples, a large and ever increasing menu of molecular tests, conventional and rapid virus isolation techniques, and determination of viral antibody response.
Direct detection of viral antigens by cytospin-enhanced direct immunofluorescence (DFA) is employed for VZV and HSV in skin lesions; HSV, VZV and adenovirus in eye swabs; RSV, influenza A and B, parainfluenza types 1-3, adenovirus and HMPV in respiratory samples; and CMV antigenemia quantification in peripheral blood cells. Hepatitis B surface antigen is detected in serum and rotavirus in stool by ELISA. Molecular methods include commercial Roche assays to detect and quantify HIV-1 RNA, HCV RNA and HBV DNA in plasma or serum, and to detect HIV-1 provirus in peripheral blood mononuclear cells. Real-time TaqMan PCR assays, developed in-house, are used to detect HSV, VZV, CMV, EBV, HHV-6, enteroviruses, parvovirus B19, human metapneumovirus, RSV, influenza A and B, avian influenza (H5N1), JC virus, BK virus, adenovirus, norovirus, RSV, and rhinovirus. HCV genotyping and HIV-1 drug resistance genotyping are also available. A variety of cell cultures are maintained for isolation of common viruses. Rapid shell vial centrifugation cultures are routinely performed for CMV. Antiviral susceptibility testing for HSV is performed by plaque reduction. Both a rapid assessment of sensitivity and a precise determination of 50% inhibitory concentration (IC 50) are available. Antibody tests are available for hepatitis A, B, C, HIV, HSV, CMV, VZV, rubella, measles, mumps, parvovirus B19, and West Nile virus by ELISA, and for EBV by IF. The detection of Clostridium difficile by cytotoxicity in cell culture remains more sensitive than toxin-ELISA and is performed in the Virology Laboratory.
A teaching schedule has been organized so that residents will become familiar with all testing done within Virology. The resident is expected to investigate problems, determine clinical correlations when needed, consult with physicians, interpret HIV western blots, and correlate virology results with pathologic findings. A close working relationship between the virology laboratory and the transplant and AIDS care programs is essential and the resident helps to communicate and maintain this relationship.
Additional Resident Duties and Responsibilities
- Consult with physicians on molecular tests
- Correlate virologic results, especially molecular tests, with clinical and pathologic findings
- Contact the Infectious Disease team and prepare case histories for the biweekly virology case presentations associated with Infectious Disease rounds
Additional Goals and Objectives for the Virology Rotation
- Become proficient in handling telephone consultations
- Interpret HIV-1 western blots and other molecular diagnostic tests
- Learn to present cases at laboratory rounds