Use of reverse-transcriptase-based HIV-1 viral load assessment to confirm low viral loads in newly diagnosed patients in Switzerland

BMC Infectious Diseases

Jörg Schüpbach¹  Jürg Böni¹  Jon B Huder¹  Cyril Shah¹  Beatrice N Vetter¹ 

[1] Swiss National Center for Retroviruses, Institute of Medical Virology, University of Zurich, Zurich, Switzerland

关键词: PERT assay;    Reverse transcriptase test;    Nucleic acid test;    Viral load underestimation;    HIV-1;   

Others  :  1134652
DOI  :  10.1186/1471-2334-14-84

 received in 2013-11-15, accepted in 2014-02-10,  发布年份 2014

【 摘 要 】

Background

Treatment-naïve patients newly diagnosed with HIV occasionally present with low viral RNA of ≤1’000 copies/ml, raising concerns about viral load underestimation. Because falsely low or undetectable viral loads might lead to inadvertent virus transmission or treatment delays, confirmation of such cases by a sequence-independent viral load test is recommended in Switzerland.

Methods

HIV-1 RNA ≤1’000 cp/ml by Roche’s or Abbott’s tests in patients newly diagnosed from 2010 to 2012 in Switzerland were subjected to viral load testing by the product-enhanced-reverse transcriptase (PERT) assay. These investigations were complemented with repeat and/or alternative viral RNA measurements.

Results

HIV-1 RNA ≤1’000 cp/ml was observed in 71 of 1814 newly diagnosed patients. The PERT assay suggested clinically relevant viral load underestimation in 7 of 32 cases that could be investigated. In four patients, the PERT viral load was 10-1’000-fold higher; this was confirmed by alternative HIV-1 RNA tests. Six of the 7 underestimates had been obtained with meanwhile outdated versions of Roche’s HIV-1 RNA test. In the seventh patient, follow-up revealed similar results for RNA and PERT based viral loads.

Conclusion

PERT assay revealed occasional severe viral load underestimation by versions of HIV-1 RNA tests meanwhile outdated. Underestimation by contemporary tests appears rare, however.

【 授权许可】

   
2014 Vetter et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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