Schockmel G A, Yerly S, Perrin L
Division of Infectious Diseases, Department of Medicine, Geneva University Hospital, Switzerland.
J Acquir Immune Defic Syndr Hum Retrovirol. 1997 Feb 1;14(2):179-83. doi: 10.1097/00042560-199702010-00013.
HIV-1 viremia is a marker of choice for staging, prognosis, and monitoring treatment efficiency in HIV infection. Among the commercial assays, the Amplicor HIV Monitor (Roche, Basel, Switzerland) test has the highest sensitivity for HIV-1 RNA quantitation in plasma with a detection limit of 200 copies per milliliter. To measure HIV-1 viremia below this threshold, boosted versions of the Amplicor assay were developed by adding a centrifugation step prior to RNA extraction and by decreasing dilution factors. In the boosted version, the increase in analytical sensitivity for HIV-1 RNA detection directly correlates with the input of plasma. For 1,500 microl of plasma, the sensitivity of the assay increases by a factor of 30. For routine clinical analysis, we use a boosted assay format with an input plasma volume of 500 microl and a lower detection limit of 20 copies/milliliter. Coefficients of intra- and interassay variation are similar to those reported for the standard assay (approximately 30%). Thirteen (45%) of 29 plasma samples of HIV-infected individuals with undetectable viremia in the standard assay had detectable viremia between 20 and 200 copies/milliliter.
HIV-1病毒血症是HIV感染分期、预后评估及监测治疗效果的首选标志物。在商业检测方法中，Amplicor HIV Monitor（罗氏公司，瑞士巴塞尔）检测对血浆中HIV-1 RNA定量具有最高灵敏度，检测限为每毫升200拷贝。为检测低于此阈值的HIV-1病毒血症，通过在RNA提取前增加离心步骤并降低稀释倍数，开发了改良版的Amplicor检测方法。在改良版中，HIV-1 RNA检测的分析灵敏度提高与血浆输入量直接相关。对于1500微升血浆，该检测方法的灵敏度提高30倍。对于常规临床分析，我们采用改良检测方法，血浆输入量为500微升，检测下限为每毫升2０拷贝。批内和批间变异系数与标准检测方法报告的相似（约30%）。在标准检测方法中病毒血症不可检测的29例HIV感染个体的血浆样本中，有13例（45%）病毒血症在每毫升20至200拷贝之间可检测到。
