Johannessen Asgeir
Department of Infectious Diseases, Oslo University Hospital, Ulleval, Oslo, Norway.
Bioanalysis. 2010 Nov;2(11):1893-908. doi: 10.4155/bio.10.120.
By the end of 2008, 4 million people were receiving antiretroviral treatment for HIV/AIDS in low- and middle-income countries. In industrialized countries, monitoring of treatment with viral load measurements and drug resistance testing is the standard of care to ensure early detection of treatment failure and a prompt switch to a fully active second-line regimen, before drug-resistant mutations accumulate. These tests, however, require highly specialized laboratories and stringent procedures for storage and shipment of plasma, and are rarely available in resource-limited settings. Therefore, treatment failure in such settings is usually not detected until patients develop severe immunodeficiency, at which stage widespread resistance is likely. Dried blood spots (DBS) are easy to collect and store, and can be a convenient alternative to plasma in settings with limited laboratory capacity. This review provides an overview of possible applications of DBS technologies in the monitoring of HIV treatment, with the main focus on viral load quantification and drug resistance testing.
到2008年底，低收入和中等收入国家有400万人正在接受抗逆转录病毒药物治疗以应对艾滋病毒/艾滋病。在工业化国家，通过病毒载量检测和耐药性测试来监测治疗情况是护理标准，以确保在耐药突变积累之前尽早发现治疗失败，并迅速改用完全有效的二线治疗方案。然而，这些检测需要高度专业化的实验室以及严格的血浆储存和运输程序，在资源有限的环境中很少能够开展。因此，在这类环境中，通常直到患者出现严重免疫缺陷才会发现治疗失败，而此时可能已经出现广泛耐药。干血斑易于采集和储存，在实验室能力有限的环境中可以作为血浆的便捷替代物。本综述概述了干血斑技术在艾滋病毒治疗监测中的可能应用，主要侧重于病毒载量定量和耐药性测试。
