Can HIV reverse transcriptase activity assay be a low-cost alternative for viral load monitoring in resource-limited settings?

BMJ Open
Soham GuptaAnita Shet

Abstract

To evaluate the performance and cost of an HIV reverse transcriptase-enzyme activity (HIV-RT) assay in comparison to an HIV-1 RNA assay for routine viral load monitoring in resource limited settings. A cohort-based longitudinal study. Two antiretroviral therapy (ART) centres in Karnataka state, South India, providing treatment under the Indian AIDS control programme. A cohort of 327 HIV-1-infected Indian adult patients initiating first-line ART. Performance and cost of an HIV-RT assay (ExaVir Load V3) in comparison to a gold standard HIV-1 RNA assay (Abbott m2000rt) in a cohort of 327 Indian patients before (WK00) and 4 weeks (WK04) after initiation of first-line therapy. Plasma viral load was determined by an HIV-1 RNA assay and an HIV-RT assay in 629 samples (302 paired samples and 25 single time point samples at WK00) obtained from 327 patients. Overall, a strong correlation of r=0.96 was observed, with good correlation at WK00 (r=0.84) and at WK04 (r=0.77). Bland-Altman analysis of all samples showed a good level of agreement with a mean difference (bias) of 0.22 log10copies/mL. The performance of ExaVir Load V3 was not negatively affected by a nevirapine/efavirenz based antiretroviral regimen. The per test cost of measurin...Continue Reading

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Citations

May 19, 2017·Journal of Clinical Microbiology·Pedro BorregoNuno Taveira
Feb 12, 2019·Pediatrics International : Official Journal of the Japan Pediatric Society·Vu Phuong Linh DangThi Phuong Vu

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Methods Mentioned

BETA
PCR
ELISA
RNA assay
RNA
genotyping
RNA assays
DNA assay

Clinical Trials Mentioned

ISRCTN79261738

Software Mentioned

Exavir
ExaVir Load analyser

Related Concepts

Related Feeds

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Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections.