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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Performance and logistical challenges of alternative HIV-1 virological monitoring options in a clinical setting of Harare, Zimbabwe
BioMed Research International, Volume 2014, Article 102598, Year 2014
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Description
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. © 2014 Pascale Ondoa et al.
Authors & Co-Authors
Ondoa, Pascale
Netherlands, Amsterdam
Amsterdam Institute for Global Health and Development
Shamu, Tinei
Zimbabwe, Harare
Newlands Clinic
Bronze, Michelle
South Africa, Johannesburg
University of the Witwatersrand
Wellington, Maureen
Zimbabwe, Harare
Newlands Clinic
Boender, T. Sonia
Netherlands, Amsterdam
Amsterdam Institute for Global Health and Development
Manting, Corry
Netherlands, Amsterdam
Amsterdam Institute for Global Health and Development
Steegen, Kim
South Africa, Johannesburg
University of the Witwatersrand
Luethy, Ruedi
Zimbabwe, Harare
Newlands Clinic
Rinke de Wit, Tobias Floris
Netherlands, Amsterdam
Amsterdam Institute for Global Health and Development
Statistics
Citations: 9
Authors: 9
Affiliations: 3
Identifiers
Doi:
10.1155/2014/102598
ISSN:
23146133
e-ISSN:
23146141
Research Areas
Health System And Policy
Infectious Diseases
Study Locations
Zimbabwe