Abstract
We thank Drs. Preiser Drexler and Drosten for their letter and share their concerns regarding HIV-1 viral load assays in resource-limited settings. The real-time RT-PCR (reverse-transcriptase polymerase chain reaction) assay they have developed had not yet been published when our review was submitted or revised. As noted in Table 1 of our review many of the current viral load assays require additional evaluation with different subtypes and others may underestimate non-B subtypes. In addition under the heading What is needed for implementation of simplified viral load testing? we state First each country must determine if the assay will quantify subtypes common in the region and is appropriate for the technical staff and laboratory equipment available. In-house assays require production optimization validation and quality assurance of all reagents which is challenging in any circumstances and would be extremely difficult in laboratories in most resource-limited settings. Real-time PCR instruments are expensive and maintenance in many places would be a problem. (excerpt)
Highlights
Bill Anderson Escobar et al.’s discussion of medically unexplained physical symptoms is useful, and could trigger a renewal of how the medical profession works [1]
“Ultrasensitive Monitoring of HIV-1 Viral Load by a Low-Cost Real-Time Reverse TranscriptionPCR Assay with Internal Control for the 5’ Long Terminal Repeat Domain” [3], we describe an inexpensive assay targeting the conserved long terminal repeat (LTR) domain of HIV-1
We demonstrated that LTR is highly suitable for the quantification of “exotic” HIV-1 genotypes: For all genotypes, except for groups N and O, the overall results of virus quantification using different assays were highly concordant
Summary
Bill Anderson Escobar et al.’s discussion of medically unexplained physical symptoms is useful, and could trigger a renewal of how the medical profession works [1]. Jose Luis Portero, Maria Rubio Tupasi et al [1] show the feasibility and cost-effectiveness of treating multidrug-resistant tuberculosis (MDR-TB) in a resource-limited setting.
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