Evaluation of filter paper transfer of whole-blood and plasma samples for quantifying HIV RNA in subjects on antiretroviral therapy in Uganda

Laura Waters, Andrew Kambugu, Hilda Tibenderana, David Meya, Laurence John, Sundhiya Mandalia, Maggie Nabankema, Irene Namugga, Thomas C Quinn, Brian Gazzard, Steven James Reynolds, Mark Nelson

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Most HIV-infected subjects on antiretroviral therapy (ART) in resource-limited settings do not undergo virologic monitoring. There is an urgent need for cheap, accessible HIV RNA assays for early diagnosis of virologic failure. We investigated filter paper transfer (FPT) of whole blood and plasma as an alternative to standard plasma-based assays for virologic monitoring in Uganda. METHODS: Whole blood (n = 306) and plasma (n = 218) from 402 subjects established on ART were spotted onto filter paper and transported to Europe for HIV RNA extraction and quantification. These results were compared to a gold standard plasma assay in Kampala. RESULTS: Of 402 ART-treated subjects, 39 (9.7%) had viremia detectable (>500 copies/mL) by local methods. Plasma FPT showed excellent agreement with gold standard, whereas whole blood yielded a large number of false-positive viral loads. CONCLUSIONS: This is the first study to investigate the use of FPT in ART-treated subjects and demonstrates that it may provide a practical, reliable method for virologic monitoring in resource-poor settings. Plasma FPT was accurate but requires centrifuge; whole blood produced a high number of false-positive results, but these were low-level. Whole blood may be sufficiently accurate if higher HIV RNA cut-offs were used to define virologic failure.

Original languageEnglish (US)
Pages (from-to)590-593
Number of pages4
JournalJournal of Acquired Immune Deficiency Syndromes
Volume46
Issue number5
DOIs
StatePublished - Dec 2007

Fingerprint

Uganda
HIV
RNA
Therapeutics
Viremia
Viral Load
Early Diagnosis

Keywords

  • Antiretroviral monitoring
  • Developing world
  • Dried blood spot
  • Viral load
  • Virologic

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Evaluation of filter paper transfer of whole-blood and plasma samples for quantifying HIV RNA in subjects on antiretroviral therapy in Uganda. / Waters, Laura; Kambugu, Andrew; Tibenderana, Hilda; Meya, David; John, Laurence; Mandalia, Sundhiya; Nabankema, Maggie; Namugga, Irene; Quinn, Thomas C; Gazzard, Brian; Reynolds, Steven James; Nelson, Mark.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 46, No. 5, 12.2007, p. 590-593.

Research output: Contribution to journalArticle

Waters, Laura ; Kambugu, Andrew ; Tibenderana, Hilda ; Meya, David ; John, Laurence ; Mandalia, Sundhiya ; Nabankema, Maggie ; Namugga, Irene ; Quinn, Thomas C ; Gazzard, Brian ; Reynolds, Steven James ; Nelson, Mark. / Evaluation of filter paper transfer of whole-blood and plasma samples for quantifying HIV RNA in subjects on antiretroviral therapy in Uganda. In: Journal of Acquired Immune Deficiency Syndromes. 2007 ; Vol. 46, No. 5. pp. 590-593.
@article{6944c6d787ee4d38b13a2b280fa97868,
title = "Evaluation of filter paper transfer of whole-blood and plasma samples for quantifying HIV RNA in subjects on antiretroviral therapy in Uganda",
abstract = "BACKGROUND: Most HIV-infected subjects on antiretroviral therapy (ART) in resource-limited settings do not undergo virologic monitoring. There is an urgent need for cheap, accessible HIV RNA assays for early diagnosis of virologic failure. We investigated filter paper transfer (FPT) of whole blood and plasma as an alternative to standard plasma-based assays for virologic monitoring in Uganda. METHODS: Whole blood (n = 306) and plasma (n = 218) from 402 subjects established on ART were spotted onto filter paper and transported to Europe for HIV RNA extraction and quantification. These results were compared to a gold standard plasma assay in Kampala. RESULTS: Of 402 ART-treated subjects, 39 (9.7{\%}) had viremia detectable (>500 copies/mL) by local methods. Plasma FPT showed excellent agreement with gold standard, whereas whole blood yielded a large number of false-positive viral loads. CONCLUSIONS: This is the first study to investigate the use of FPT in ART-treated subjects and demonstrates that it may provide a practical, reliable method for virologic monitoring in resource-poor settings. Plasma FPT was accurate but requires centrifuge; whole blood produced a high number of false-positive results, but these were low-level. Whole blood may be sufficiently accurate if higher HIV RNA cut-offs were used to define virologic failure.",
keywords = "Antiretroviral monitoring, Developing world, Dried blood spot, Viral load, Virologic",
author = "Laura Waters and Andrew Kambugu and Hilda Tibenderana and David Meya and Laurence John and Sundhiya Mandalia and Maggie Nabankema and Irene Namugga and Quinn, {Thomas C} and Brian Gazzard and Reynolds, {Steven James} and Mark Nelson",
year = "2007",
month = "12",
doi = "10.1097/QAI.0b013e318159d7f4",
language = "English (US)",
volume = "46",
pages = "590--593",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Evaluation of filter paper transfer of whole-blood and plasma samples for quantifying HIV RNA in subjects on antiretroviral therapy in Uganda

AU - Waters, Laura

AU - Kambugu, Andrew

AU - Tibenderana, Hilda

AU - Meya, David

AU - John, Laurence

AU - Mandalia, Sundhiya

AU - Nabankema, Maggie

AU - Namugga, Irene

AU - Quinn, Thomas C

AU - Gazzard, Brian

AU - Reynolds, Steven James

AU - Nelson, Mark

PY - 2007/12

Y1 - 2007/12

N2 - BACKGROUND: Most HIV-infected subjects on antiretroviral therapy (ART) in resource-limited settings do not undergo virologic monitoring. There is an urgent need for cheap, accessible HIV RNA assays for early diagnosis of virologic failure. We investigated filter paper transfer (FPT) of whole blood and plasma as an alternative to standard plasma-based assays for virologic monitoring in Uganda. METHODS: Whole blood (n = 306) and plasma (n = 218) from 402 subjects established on ART were spotted onto filter paper and transported to Europe for HIV RNA extraction and quantification. These results were compared to a gold standard plasma assay in Kampala. RESULTS: Of 402 ART-treated subjects, 39 (9.7%) had viremia detectable (>500 copies/mL) by local methods. Plasma FPT showed excellent agreement with gold standard, whereas whole blood yielded a large number of false-positive viral loads. CONCLUSIONS: This is the first study to investigate the use of FPT in ART-treated subjects and demonstrates that it may provide a practical, reliable method for virologic monitoring in resource-poor settings. Plasma FPT was accurate but requires centrifuge; whole blood produced a high number of false-positive results, but these were low-level. Whole blood may be sufficiently accurate if higher HIV RNA cut-offs were used to define virologic failure.

AB - BACKGROUND: Most HIV-infected subjects on antiretroviral therapy (ART) in resource-limited settings do not undergo virologic monitoring. There is an urgent need for cheap, accessible HIV RNA assays for early diagnosis of virologic failure. We investigated filter paper transfer (FPT) of whole blood and plasma as an alternative to standard plasma-based assays for virologic monitoring in Uganda. METHODS: Whole blood (n = 306) and plasma (n = 218) from 402 subjects established on ART were spotted onto filter paper and transported to Europe for HIV RNA extraction and quantification. These results were compared to a gold standard plasma assay in Kampala. RESULTS: Of 402 ART-treated subjects, 39 (9.7%) had viremia detectable (>500 copies/mL) by local methods. Plasma FPT showed excellent agreement with gold standard, whereas whole blood yielded a large number of false-positive viral loads. CONCLUSIONS: This is the first study to investigate the use of FPT in ART-treated subjects and demonstrates that it may provide a practical, reliable method for virologic monitoring in resource-poor settings. Plasma FPT was accurate but requires centrifuge; whole blood produced a high number of false-positive results, but these were low-level. Whole blood may be sufficiently accurate if higher HIV RNA cut-offs were used to define virologic failure.

KW - Antiretroviral monitoring

KW - Developing world

KW - Dried blood spot

KW - Viral load

KW - Virologic

UR - http://www.scopus.com/inward/record.url?scp=36549088200&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=36549088200&partnerID=8YFLogxK

U2 - 10.1097/QAI.0b013e318159d7f4

DO - 10.1097/QAI.0b013e318159d7f4

M3 - Article

C2 - 18193501

AN - SCOPUS:36549088200

VL - 46

SP - 590

EP - 593

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

IS - 5

ER -