Information de reference pour ce titreAccession Number: | 00126334-200712150-00010.
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Author: | Waters, Laura MRCP *; Kambugu, Andrew MD, MMed +; Tibenderana, Hilda MD +; Meya, David MD +; John, Laurence MRCP *+; Mandalia, Sundhiya MSc *; Nabankema, Maggie +; Namugga, Irene +; Quinn, Thomas C MD ++[S]; Gazzard, Brian FRCP *; Reynolds, Steven J MD ++[S]; Nelson, Mark MD *
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Institution: | From the *St. Stephens AIDS Trust, Chelsea & Westminster Hospital, London, UK; +Infectious Disease Institute, Makerere University, Kampala, Uganda; ++National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; and the [S]Johns Hopkins University School of Medicine, Baltimore, MD.
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Title: | |
Source: | JAIDS Journal of Acquired Immune Deficiency Syndromes. 46(5):590-593, December 15, 2007.
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Abstract: | Background: Most HIV-infected subjects on antiretroviral therapy (ART) in resource-limited settings do not undergo virologic monitoring. There is an urgent need for cheap, accessible HIV RNA assays for early diagnosis of virologic failure. We investigated filter paper transfer (FPT) of whole blood and plasma as an alternative to standard plasma-based assays for virologic monitoring in Uganda.
Methods: Whole blood (n = 306) and plasma (n = 218) from 402 subjects established on ART were spotted onto filter paper and transported to Europe for HIV RNA extraction and quantification. These results were compared to a gold standard plasma assay in Kampala.
Results: Of 402 ART-treated subjects, 39 (9.7%) had viremia detectable (>500 copies/mL) by local methods. Plasma FPT showed excellent agreement with gold standard, whereas whole blood yielded a large number of false-positive viral loads.
Conclusions: This is the first study to investigate the use of FPT in ART-treated subjects and demonstrates that it may provide a practical, reliable method for virologic monitoring in resource-poor settings. Plasma FPT was accurate but requires centrifuge; whole blood produced a high number of false-positive results, but these were low-level. Whole blood may be sufficiently accurate if higher HIV RNA cut-offs were used to define virologic failure.
(C) 2007 Lippincott Williams & Wilkins, Inc.
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Author Keywords: | dried blood spot; viral load; developing world; antiretroviral monitoring; virologic.
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References: | 1. World Health Organization. Progress in scaling up HIV treatment in low and middle-income countries, June 2006. Available at: http://www.who.int/hiv/toronto20...- ouverture dans une nouvelle fenêtre. Accessed July 7, 2007.
2. Crowe S, Turnbull S, Oelrichs R, et al. Monitoring of human immunodeficiency virus infection in resource-constrained countries. Clin Infect Dis. 2003;37(Suppl 1):S25-S35.
3. Panteleeff DD, John G, Nduati R, et al. Rapid method for screening dried blood samples on filter paper for human immunodeficiency virus type 1 DNA. J Clin Microbiol. 1999;37:350-353.
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5. Mwaba P, Cassol S, Nunn A, et al. Whole blood versus plasma spots for measurement of HIV-1 viral load in HIV-infected African patients. Lancet. 2003;362:2067-2068.
6. Holodniy M. HIV-1 load quantitation: a 17-year perspective. J Infect Dis. 2006;194(Suppl 1):S38-S44.
7. World Health Organization. Antiretroviral therapy for adults and adolescents in resource limited settings: towards universal access (2006 revision). Available at: http://www.who.int/hiv/pub/guide...- ouverture dans une nouvelle fenêtre. Accessed July 7, 2007.
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Language: | English.
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Document Type: | Brief Report: Clinical Science.
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Journal Subset: | Clinical Medicine. Behavioral & Social Sciences.
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ISSN: | 1525-4135
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DOI Number: | https://dx.doi.org/10.1097/QAI.0...- ouverture dans une nouvelle fenêtre
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