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5th International AIDS Society Conference on HIV Pathogenesis and TreatmentCape Town - July 19 - 22, 2009 |
CORRELATION BETWEEN HIV-1 VIRAL LOAD QUANTIFICATION MEASURED IN PLASMA, DRIED BLOOD SPOTS, AND DRIED PLASMA SPOTS USING THE ROCHE Cobas TaqMan ASSAY
IAS Conf HIV Pathog Treat 2009 Jul 19-22;5th: Abstract No. MOPDD102
M. Andreotti
1, M. Pirillo1, G. Guidotti2, S. Ceffa2, G. Paturzo2, P. Germano2, R. Luhanga3, D. Chimwaza4, M.G. Mancini1, S. Vella1, M.C. Marazzi2, L. Palombi5, M. Giuliano1
1Istituto Superiore di Sanità, Rome, Italy, 2DREAM Program, Community of S. Egidio, Rome, Italy, 3DREAM Program, Community of S. Egidio, Blantyre, Malawi, 4DREAM Program, Community of S. Egidio, Lilongwe, Malawi, 5University of Tor Vergata, Rome, Italy
BACKGROUND: The use of dried blood spots for viral load determination could greatly increase access to treatment monitoring of HIV patients in resource-limited countries. In this study we optimized and evaluated the performance of the Roche Cobas Taqman assay after extraction with the Boom technology.
METHODS: EDTA blood samples from 31 HIV-infected patients enrolled in the DREAM (Drug Resource Enhancement against AIDS and Malnutrition) Program of the S. Egidio Community in Malawi, were used to prepare 47 dried blood spots (DBS) and 28 dried plasma spots (DPS) on Whatman 903 card. DBS and DPS were stored a - 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 the standard.
RESULTS: In samples with HIV-RNA between 3.5 logs and 5.3 logs (22 DBS and 19 DPS) there was a high correlation between measures in plasma and the DBS/DPS (r=0.897 and 0.894 respectively, p<0.001). Overall, viral load values in DBS and DPS tended to be lower than in plasma with mean (SD) differences of 0.25 log (0.29) for DBS and of 0.24 (0.29) for DPS. Samples with HIV-RNA below 50 copies/ml were correctly identified in 19/20 cases in DBS and in 4/4 cases in DPS. In one case HIV-RNA was undetectable in plasma while the DBS detected 2.74 log copies. In 6 DBS samples and 5 DPS samples (with corresponding plasma levels of HIV-RNA ranging between 2.1 and 3.3 logs) HIV-RNA was not detectable.
CONCLUSIONS: Reliable results were obtaines with both DBS and DPS when HIV-RNA was >3.5 logs copies/ml. The assay can also be reliably used to identify samples with undetectable HIV-RNA. Our results support the use of DBS/DPS to detect virologic failure in resource-limited settings.
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2009-07-22
MOPDD102
Operations Research to Improve Laboratory Diagnosis and Monitoring
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