Important note: Information in this article was accurate in March 2001. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, March 26, 2001
Michael Greer, staff medical writer
"Commercial HIV 1 qualitative DNA PCR tests have the potential to detect virus in patients in whom antibody tests may be ineffective," explained M. Bogh and colleagues at the Staten Serum Institute. "However, the genetic diversity of HIV 1 raises concern about the ability of the PCR tests to detect all current subtypes."
Bogh et al. discovered that these concerns are well founded. Testing the accuracy of the standard Amplicor screen, they found that a small but significant proportion of confirmed HIV patients tested negative for this assay.
Although all patients infected with B, D, or G subtypes tested positive, sensitivities for other subtypes ranged from 98% for subtype C to 79% for subtype E, the researchers said. Moreover, their study showed that the Amplicor test failed to detect any patient with HIV subtype F, although the fact that only two members of the study cohort carried this subtype limits conclusions that can be drawn from this result.
Low but detectable reactivities were found in 9% of the non-B positive samples ("Subtype-specific problems with qualitative Amplicor HIV-1 DNA PCR test," J Clin Virol 2001 Feb;20(3):149-53.
Enhancing the Amplicor test with the SK145/SKCC1B primer set enabled it to correctly detect six of eight false-negatives, the researchers noted.
"This study confirms that the Amplicor HIV 1 test does not detect all subtypes with equivalent sensitivity," Bogh and colleagues concluded. "Thus, it is preferable to add the SK145/SKCC1B primers to the standard test, where infection with non-B subtype is suspected."
The corresponding author for this report is M. Bogh, Statens Serum Institute, Retrovirus Laboratory, Dept. of Virology, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
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