AIDSWEEKLY Plus; Monday, July 12, 2004
Staff Medical Writers

According to recent research from Israel, "Quantitation assays of HIV-1 RNA used currently were designed and optimized for subtype B viruses. However, infection with non-B HIV viruses has become more common worldwide. Unfortunately, little information is available regarding the suitability of these assays for measurement of viral load in specific non-B subtypes."

"The performance of two commercial HIV-1 RNA quantitation assays was evaluated in 82 HIV subtype C-infected patients and in 43 HIV-1 subtype B-infected patients. Blood samples were tested by the Amplicor HIV-1 Monitor Assay, Version 1.5, and by the nucleic acid sequence-based amplification HIV-1 assay (NucliSens).

"The results were compared by using a paired, two-tailed Student's t-test; the difference between the assays was found to be significant only for subtype C. Discordant results (>0.6 log difference) between the two assays were detected in 39% of subtype C samples, compared to 23.2% of subtype B samples. In all cases in which a discordant result was detected," B.S. Gottesman and coworkers reported, "the lower results were obtained by the NucliSens assay."

"Discordant results between CD4 and viral load (CD4<200 cells/ml with a viral load <5,000 copies/ml) were observed in eight of the subtype C-infected patients when a viral load was measured by NucliSens (9.7%), compared to three patients (3.6%) when measured by the Amplicor assay," the authors continued.

Gottesman concluded, "In patients with HIV subtype C infection, measurement of HIV RNA by the NucliSens assay resulted in a significant underestimation of the viral load as compared to the Amplicor assay. As a consequence, such an underestimation may result in sub-optimal care of patients infected with HIV subtype C."

Gottesman and colleagues published their study in Journal of Medical Virology (Measurement of HIV RNA in patients infected by subtype C by assays optimized for subtype B results in an underestimation of the viral load. J Med Virol. 2004 Jun;73(2):167-71.

For additional information, contact M.Y. Chowers, Meir Hospital, Infectious Diseases Unit, 59 Tsharnichovski St., IL-44281 Kefar Sava, Israel.

Publisher contact information for the Journal of Medical Virology is: Wiley-Liss, Division John Wiley & Sons Inc., 605 Third Avenue, New York, NY 10158-0012 USA.

The information in this article comes under the major subject areas of AIDS & HIV, Biotechnology, Genomics and Genetic and Diagnostics.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Gottesman BS, Grosman Z, Lorber M, et al., "Measurement of HIV RNA in patients infected by subtype C by assays optimized for subtype B results in an underestimation of the viral load", J Med Virol. 2004 Jun;73(2):167-71.

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