Your browser doesn't support javascript.
loading
Performance and logistical challenges of alternative HIV-1 virological monitoring options in a clinical setting of Harare, Zimbabwe.
Ondoa, Pascale; Shamu, Tinei; Bronze, Michelle; Wellington, Maureen; Boender, Tamara Sonia; Manting, Corry; Steegen, Kim; Luethy, Rudi; Rinke de Wit, Tobias.
Afiliação
  • Ondoa P; Amsterdam Institute for Global Health and Development (AIGHD), Department of Global Health, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands.
  • Shamu T; Newlands Clinic, 56 Enterprise Road, Newlands, Harare, Zimbabwe.
  • Bronze M; Department of Molecular Medicine and Haematology, University of the Witwatersrand 7 York Road, Parktown, Johannesburg 2193, South Africa.
  • Wellington M; Newlands Clinic, 56 Enterprise Road, Newlands, Harare, Zimbabwe.
  • Boender TS; Amsterdam Institute for Global Health and Development (AIGHD), Department of Global Health, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands.
  • Manting C; Amsterdam Institute for Global Health and Development (AIGHD), Department of Global Health, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands.
  • Steegen K; Department of Molecular Medicine and Haematology, University of the Witwatersrand 7 York Road, Parktown, Johannesburg 2193, South Africa.
  • Luethy R; Newlands Clinic, 56 Enterprise Road, Newlands, Harare, Zimbabwe.
  • Rinke de Wit T; Amsterdam Institute for Global Health and Development (AIGHD), Department of Global Health, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands.
Biomed Res Int ; 2014: 102598, 2014.
Article em En | MEDLINE | ID: mdl-25025031
We evaluated a low-cost virological failure assay (VFA) on plasma and dried blood spot (DBS) specimens from HIV-1 infected patients attending an HIV clinic in Harare. The results were compared to the performance of the ultrasensitive heat-denatured p24 assay (p24). The COBAS AmpliPrep/COBAS TaqMan HIV-1 test, version 2.0, served as the gold standard. Using a cutoff of 5,000 copies/mL, the plasma VFA had a sensitivity of 94.5% and specificity of 92.7% and was largely superior to the VFA on DBS (sensitivity = 61.9%; specificity = 99.0%) or to the p24 (sensitivity = 54.3%; specificity = 82.3%) when tested on 302 HIV treated and untreated patients. However, among the 202 long-term ART-exposed patients, the sensitivity of the VFA decreased to 72.7% and to 35.7% using a threshold of 5,000 and 1,000 RNA copies/mL, respectively. We show that the VFA (either on plasma or on DBS) and the p24 are not reliable to monitor long-term treated, HIV-1 infected patients. Moreover, achieving acceptable assay sensitivity using DBS proved technically difficult in a less-experienced laboratory. Importantly, the high level of virological suppression (93%) indicated that quality care focused on treatment adherence limits virological failure even when PCR-based viral load monitoring is not available.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Virologia / Infecções por HIV / HIV-1 / Proteína do Núcleo p24 do HIV Limite: Humans País como assunto: Africa Idioma: En Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Virologia / Infecções por HIV / HIV-1 / Proteína do Núcleo p24 do HIV Limite: Humans País como assunto: Africa Idioma: En Ano de publicação: 2014 Tipo de documento: Article