Abstract

Background The use of simplified methods for viral load determination could greatly increase access to treatment monitoring of HIV patients in resource-limited countries. Objective The aim of the present study was to optimize and evaluate the performance of the Roche COBAS Taqman assay in HIV-RNA quantification from dried blood spots (DBS) and dried plasma spots (DPS). Study design EDTA blood samples from 108 HIV-infected women were used to prepare 129 DBS and 76 DPS on Whatman 903 card. DBS and DPS were stored at −20 °C. HIV-1 RNA was extracted from DBS/DPS using the MiniMAG system (bioMerieux). Amplification and detection were performed using the Roche COBAS TaqMan assay. Plasma viral load results were used as standard. Results There was a high correlation between measures of viral load in plasma and in DBS/DPS ( r = 0.96 and 0.85 respectively, P < 0.001). Overall, viral load values in DBS and DPS tended to be lower than in plasma with mean (SD) differences of 0.32 log (0.22) for DBS and of 0.35 (0.33) for DPS. Detection rates were 96.4% for DBS and 96.1% for DPS in samples with corresponding plasma values >3.0 log copies/ml. Samples with HIV-RNA below 50 copies/ml were correctly identified in 18/19 DBS and in 7/7 DPS. Conclusions Both DBS and DPS provided results highly correlated to the plasma values. High detection rate was obtained with both DBS and DPS when HIV-RNA was >3.0 log copies/ml. Our results support the use of DBS/DPS to detect virologic failure in resource-limited settings.

Highlights

  • The use of simplified methods for viral load determination could greatly increase access to treatment monitoring of HIV patients in resource-limited countries

  • In the present study we evaluated the performance of the Roche COBAS TaqMan assay in quantifying HIV-RNA from both dried blood spots and dried plasma spots obtained from patients in Malawi

  • The performance in HIV-RNA quantification from dried blood spots (DBS) and dried plasma spots (DPS) of the new methodologies for viral load determination using a real-time PCR have been evaluated in few studies,[9,10,12,15] and in our work we aimed to validate the use of the Roche COBAS TaqMan assay

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Summary

Introduction

The use of simplified methods for viral load determination could greatly increase access to treatment monitoring of HIV patients in resource-limited countries. Detection rates were 96.4% for DBS and 96.1% for DPS in samples with corresponding plasma values >3.0 log copies/ml. High detection rate was obtained with both DBS and DPS when HIV-RNA was >3.0 log copies/ml. Our results support the use of DBS/DPS to detect virologic failure in resource-limited settings. Evidence has been accumulating that identification of treatment failure based only on clinical or immunological criteria, Quantification of HIV-RNA from filter papers has been evaluated in several studies using different techniques that have provided variable results.[4,5,6,7,8,9] In general, satisfactory results have been obtained at relatively high viral load, while samples with values near the cut-off level have not produced reliable data.[10,11,12]. Andreotti et al / Journal of Clinical Virology 47 (2010) 4–7

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