Department of Laboratory Medicine, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
J Infect Chemother. 2011 Dec;17(6):863-5. doi: 10.1007/s10156-011-0263-9. Epub 2011 Jun 14.
We encountered a human immunodeficiency virus (HIV)-1 in which the viral load was undetectable with the Cobas TaqMan HIV-1 ver. 1.0 (CTM v.1.0) in a patient with acute HIV-1 infection. The CTM v.1.0 assay showed more than 1,000-fold underestimation compared with the subsequent Cobas Amplicor Monitor v.1.5 assay. Because five mismatches to the CTM v.1.0 assay probe in the HIV-1 virus in the patient were disclosed by the manufacturer, partial gag regions of the HIV genome were directly sequenced from the patient's plasma viral RNA. The detected single nucleotide point mutations were located near the 5'-end of the Cobas Amplicor Monitor probe. Clinicians should be very careful in making interpretations when indeterminate Western blot analysis results and a low or even undetectable HIV-1 viral load are encountered with the CTM HIV-1 ver. 1.0 assay in patients with suspected acute HIV infection. Repeating Western blot analysis is essential before considering a low HIV-1 viral load to be a false-positive result.
我们遇到了一例人类免疫缺陷病毒（HIV）-1 感染者，该患者急性 HIV-1 感染，采用 Cobas TaqMan HIV-1 ver. 1.0（CTM v.1.0）检测时病毒载量不可测。与后续的 Cobas Amplicor Monitor v.1.5 检测相比，CTM v.1.0 检测的结果低估了超过 1000 倍。由于制造商披露了患者 HIV-1 病毒与 CTM v.1.0 检测探针的 5 个错配，我们直接从患者血浆病毒 RNA 中对 HIV 基因组的 gag 区进行了部分测序。检测到的单核苷酸点突变位于 Cobas Amplicor Monitor 探针的 5'-端附近。当怀疑急性 HIV 感染的患者采用 CTM HIV-1 ver. 1.0 检测时，出现不确定的 Western blot 分析结果和低甚至不可测的 HIV-1 病毒载量时，临床医生在进行解释时应非常谨慎。在考虑 HIV-1 病毒载量为假阳性结果之前，重复 Western blot 分析是必不可少的。
