Measurement of HIV-1 Viral Load for Drug Resistance Surveillance using Dried Blood Spots: Literature Review and Modeling of Contribution of DNA and RNA

• Published in: AIDS reviews Vol. 16; no. 3; p. 1
• Main Author: Parkin, Neil T
• Format: Journal Article
• Language: English
• Published: 01.09.2014
• Subjects: Human immunodeficiency virus 1
• ISSN: 1139-6121; 1698-6997

World Health Organization-recommended surveys of acquired HIV-1 drug resistance include assessment of HIV-1 viral load suppression to levels below 1,000 copies/ml and drug resistance-associated mutation patterns in subjects on antiretroviral therapy. Surveys are being conducted in regions of the world that cannot support the collection, storage, and shipping of frozen plasma. Therefore, dried blood spots are often the specimen type of choice for both genotyping and viral load measurement. Amongst published studies of commercial assay performance with dried blood spots, the bioMerieux EasyQ(R) and Abbott RealTime assays tended to show high (> 90%) specificity and sensitivity; the Biocentric Generic or Roche TaqMan(R) assays tended to show high sensitivity but lower specificity, using a 1,000 copies/ml threshold. To avoid misclassifying subjects with plasma viral load suppression, the World Health Organization-recommended threshold of 1,000 copies/ml can be applied only when an assay that can distinguish between DNA and RNA is used (e.g. bioMerieux EasyQ(R) or Abbott RealTime).