Galli Rick, Merrick Linda, Friesenhahn Michel, Ziermann Rainer
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
J Clin Virol. 2005 Dec;34(4):245-52. doi: 10.1016/j.jcv.2004.12.012.
Plasma human immunodeficiency virus type 1 (HIV-1) RNA level is an important parameter for patient management, yet viral load assays from different manufacturers are not standardized.
In this study, we evaluated the concordance between test results obtained for 1,000 plasma specimens collected from HIV-1-infected individuals measured with the VERSANT HIV-1 RNA 3.0 assay (bDNA) and the COBAS AMPLICOR HIV-1 MONITOR 1.5 test (PCR). We compared viral load values obtained by each of these assays throughout their dynamic ranges, with particular focus on samples with low viral load (i.e. 50-250 copies/mL), and calculated the estimated distribution of distinct plasma viral load levels for the entire study population modeled from the data observed in the study.
We found that these two assays show excellent agreement, with a correlation (R(2)) of 0.957 and a slope of 1.004. The mean difference in viral load values between the two assays was less than 0.10-log(10) throughout the dynamic range and 98.2% of all samples had bDNA and PCR results within 0.5-log(10) of each other, a difference that is within the range considered to be a minimal change in plasma viremia. Moreover, the two assays show very similar results across all assay ranges tested. The estimated prevalence of samples with results <50 copies/mL, 50-250 copies/mL, and 250-500,000 copies/mL were 41.6%, 7.7%, and 49.7%, respectively, by the bDNA assay, and 42.4%, 6.9%, and 50.7%, respectively, by the PCR assay.
Based on our findings from 1,000 clinical specimens, we do not see the need to re-establish a baseline value or apply a conversion factor when switching from one assay to the other. Since the majority of our patient population likely is infected with subtype B virus, it is unclear if our findings will apply to other patient populations with a greater incidence of infection with non-B subtypes.
血浆1型人类免疫缺陷病毒(HIV-1)RNA水平是患者管理的重要参数,但不同厂家的病毒载量检测方法未实现标准化。
在本研究中,我们评估了使用VERSANT HIV-1 RNA 3.0检测法(分支DNA法)和COBAS AMPLICOR HIV-1 MONITOR 1.5检测法(聚合酶链反应法)对1000份从HIV-1感染者采集的血浆标本检测结果之间的一致性。我们比较了这两种检测法在其动态范围内获得的病毒载量值,特别关注低病毒载量(即50 - 250拷贝/毫升)的样本,并根据研究中观察到的数据计算了整个研究人群不同血浆病毒载量水平的估计分布情况。
我们发现这两种检测法显示出极佳的一致性,相关性(R²)为0.957,斜率为1.004。在整个动态范围内,两种检测法的病毒载量值平均差异小于0.10对数(10),并且所有样本中有98.2%的分支DNA法和聚合酶链反应法结果相差在0.5对数(10)以内,此差异在被认为是血浆病毒血症最小变化的范围内。此外,在所有测试的检测范围内,这两种检测法显示出非常相似的结果。通过分支DNA法检测,结果<50拷贝/毫升、50 - 250拷贝/毫升和250 - 500,000拷贝/毫升的样本估计患病率分别为41.6%、7.7%和49.7%,通过聚合酶链反应法检测的相应患病率分别为42.4%、6.9%和50.7%。
基于我们对1000份临床标本的研究结果,我们认为在从一种检测法转换到另一种检测法时,无需重新建立基线值或应用转换因子。由于我们的大多数患者群体可能感染的是B亚型病毒,尚不清楚我们的研究结果是否适用于感染非B亚型病毒发生率更高的其他患者群体。