Systematic review of the performance of HIV viral load technologies on plasma samples.

<h4>Background</h4>Viral load (VL) monitoring is the standard of care in developing country settings for detecting HIV treatment failure. Since 2010 the World Health Organization has recommended a phase-in approach to VL monitoring in resource-limited settings. We conducted a systematic...

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Main Authors: Kimberly A Sollis, Pieter W Smit, Susan Fiscus, Nathan Ford, Marco Vitoria, Shaffiq Essajee, David Barnett, Ben Cheng, Suzanne M Crowe, Thomas Denny, Alan Landay, Wendy Stevens, Vincent Habiyambere, Jos Perrins, Rosanna W Peeling
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Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0085869
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author Kimberly A Sollis
Pieter W Smit
Susan Fiscus
Nathan Ford
Marco Vitoria
Shaffiq Essajee
David Barnett
Ben Cheng
Suzanne M Crowe
Thomas Denny
Alan Landay
Wendy Stevens
Vincent Habiyambere
Jos Perrins
Rosanna W Peeling
author_facet Kimberly A Sollis
Pieter W Smit
Susan Fiscus
Nathan Ford
Marco Vitoria
Shaffiq Essajee
David Barnett
Ben Cheng
Suzanne M Crowe
Thomas Denny
Alan Landay
Wendy Stevens
Vincent Habiyambere
Jos Perrins
Rosanna W Peeling
author_sort Kimberly A Sollis
collection DOAJ
description <h4>Background</h4>Viral load (VL) monitoring is the standard of care in developing country settings for detecting HIV treatment failure. Since 2010 the World Health Organization has recommended a phase-in approach to VL monitoring in resource-limited settings. We conducted a systematic review of the accuracy and precision of HIV VL technologies for treatment monitoring.<h4>Methods and findings</h4>A search of Medline and Embase was conducted for studies evaluating the accuracy or reproducibility of commercially available HIV VL assays. 37 studies were included for review including evaluations of the Amplicor Monitor HIV-1 v1.5 (n = 25), Cobas TaqMan v2.0 (n = 11), Abbott RealTime HIV-1 (n = 23), Versant HIV-1 RNA bDNA 3.0 (n = 15), Versant HIV-1 RNA kPCR 1.0 (n = 2), ExaVir Load v3 (n = 2), and NucliSens EasyQ v2.0 (n = 1). All currently available HIV VL assays are of sufficient sensitivity to detect plasma virus levels at a lower detection limit of 1,000 copies/mL. Bias data comparing the Abbott RealTime HIV-1, TaqMan v2.0 to the Amplicor Monitor v1.5 showed a tendency of the Abbott RealTime HIV-1 to under-estimate results while the TaqMan v2.0 overestimated VL counts. Compared to the Amplicor Monitor v1.5, 2-26% and 9-70% of results from the Versant bDNA 3.0 and Abbott RealTime HIV-1 differed by greater than 0.5log10. The average intra and inter-assay variation of the Abbott RealTime HIV-1 were 2.95% (range 2.0-5.1%) and 5.44% (range 1.17-30.00%) across the range of VL counts (2log10-7log10).<h4>Conclusions</h4>This review found that all currently available HIV VL assays are of sufficient sensitivity to detect plasma VL of 1,000 copies/mL as a threshold to initiate investigations of treatment adherence or possible treatment failure. Sources of variability between VL assays include differences in technology platform, plasma input volume, and ability to detect HIV-1 subtypes. Monitoring of individual patients should be performed on the same technology platform to ensure appropriate interpretation of changes in VL. Prospero registration # CD42013003603.
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spelling doaj-art-4e95246e3d4b4fb79e8889ea5045d9db2025-07-30T05:31:45ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0192e8586910.1371/journal.pone.0085869Systematic review of the performance of HIV viral load technologies on plasma samples.Kimberly A SollisPieter W SmitSusan FiscusNathan FordMarco VitoriaShaffiq EssajeeDavid BarnettBen ChengSuzanne M CroweThomas DennyAlan LandayWendy StevensVincent HabiyambereJos PerrinsRosanna W Peeling<h4>Background</h4>Viral load (VL) monitoring is the standard of care in developing country settings for detecting HIV treatment failure. Since 2010 the World Health Organization has recommended a phase-in approach to VL monitoring in resource-limited settings. We conducted a systematic review of the accuracy and precision of HIV VL technologies for treatment monitoring.<h4>Methods and findings</h4>A search of Medline and Embase was conducted for studies evaluating the accuracy or reproducibility of commercially available HIV VL assays. 37 studies were included for review including evaluations of the Amplicor Monitor HIV-1 v1.5 (n = 25), Cobas TaqMan v2.0 (n = 11), Abbott RealTime HIV-1 (n = 23), Versant HIV-1 RNA bDNA 3.0 (n = 15), Versant HIV-1 RNA kPCR 1.0 (n = 2), ExaVir Load v3 (n = 2), and NucliSens EasyQ v2.0 (n = 1). All currently available HIV VL assays are of sufficient sensitivity to detect plasma virus levels at a lower detection limit of 1,000 copies/mL. Bias data comparing the Abbott RealTime HIV-1, TaqMan v2.0 to the Amplicor Monitor v1.5 showed a tendency of the Abbott RealTime HIV-1 to under-estimate results while the TaqMan v2.0 overestimated VL counts. Compared to the Amplicor Monitor v1.5, 2-26% and 9-70% of results from the Versant bDNA 3.0 and Abbott RealTime HIV-1 differed by greater than 0.5log10. The average intra and inter-assay variation of the Abbott RealTime HIV-1 were 2.95% (range 2.0-5.1%) and 5.44% (range 1.17-30.00%) across the range of VL counts (2log10-7log10).<h4>Conclusions</h4>This review found that all currently available HIV VL assays are of sufficient sensitivity to detect plasma VL of 1,000 copies/mL as a threshold to initiate investigations of treatment adherence or possible treatment failure. Sources of variability between VL assays include differences in technology platform, plasma input volume, and ability to detect HIV-1 subtypes. Monitoring of individual patients should be performed on the same technology platform to ensure appropriate interpretation of changes in VL. Prospero registration # CD42013003603.https://doi.org/10.1371/journal.pone.0085869
spellingShingle Kimberly A Sollis
Pieter W Smit
Susan Fiscus
Nathan Ford
Marco Vitoria
Shaffiq Essajee
David Barnett
Ben Cheng
Suzanne M Crowe
Thomas Denny
Alan Landay
Wendy Stevens
Vincent Habiyambere
Jos Perrins
Rosanna W Peeling
Systematic review of the performance of HIV viral load technologies on plasma samples.
PLoS ONE
title Systematic review of the performance of HIV viral load technologies on plasma samples.
title_full Systematic review of the performance of HIV viral load technologies on plasma samples.
title_fullStr Systematic review of the performance of HIV viral load technologies on plasma samples.
title_full_unstemmed Systematic review of the performance of HIV viral load technologies on plasma samples.
title_short Systematic review of the performance of HIV viral load technologies on plasma samples.
title_sort systematic review of the performance of hiv viral load technologies on plasma samples
url https://doi.org/10.1371/journal.pone.0085869
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