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Viral load monitoring

Trevor Peter, Dennis Ellenberger, Andrea A Kim, Debrah Boeras, Tsehaynesh Messele, Teri Roberts, Wendy Stevens, Ilesh Jani, Alash'le Abimiku, Nathan Ford, Zachary Katz, John N Nkengasong
Scaling up access to HIV viral load testing for individuals undergoing antiretroviral therapy in low-resource settings is a global health priority, as emphasised by research showing the benefits of suppressed viral load for the individual and the whole population. Historically, large-scale diagnostic test implementation has been slow and incomplete because of service delivery and other challenges. Building on lessons from the past, in this Personal View we propose a new framework to accelerate viral load scale-up and ensure equitable access to this essential test...
October 20, 2016: Lancet Infectious Diseases
Angelos Hatzakis, Helen Papachristou, Sangeetha J Nair, Jacqueline Fortunko, Tracy Foote, HeeCheol Kim, Tashi L Peling, Andrew J Worlock
BACKGROUND: Quantitation of HIV-RNA is critically important for diagnosis, prognosis, treatment, monitoring and assessment of infectivity in HIV-1 infection. The objective of this study was to assess performance characteristics of the Aptima HIV-1 Quant Dx assay (Aptima), a new transcription mediated amplification (TMA), fully integrated and automated assay from Hologic Inc., San Diego, CA, USA. The analytical sensitivity, analytical specificity, precision and detection of HIV-1 subtypes were tested based on commercially available international standards or panels...
October 21, 2016: Virology Journal
Sanjiv M Baxi, Rebecca Scherzer, Vasantha Jotwani, Michelle M Estrella, Alison G Abraham, Chirag R Parikh, Michael R Bennett, Mardge H Cohen, Marek J Nowicki, Deborah R Gustafson, Anjali Sharma, Mary A Young, Michael G Shlipak
BACKGROUND: Urine biomarkers have helped identify persons at risk for progressing to kidney disease in the setting of HIV infection. We explored factors associated with changes in three urine biomarkers over 10 years among women living with HIV. METHODS: Prospective cohort of 294 HIV-infected women from the multicenter Women's Interagency HIV Study (WIHS). Predictors included HIV viral and immunological parameters, co-morbid conditions and health-related behaviors...
October 18, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Thahira Jamal Mohamed, Sirinya Teeraananchai, Stephen J Kerr, Wanatpreeya Phongsamart, Nik Khairulddin Nik Yusoff, Rawiwan Hansudewechakul, Penh Sun Ly, Lam Van Nguyen, Tavitiya Sudjaritruk, Pagakrong Lumbiganon, Viet Chau Do, Nia Kurniati, Nagalingeswaran Kumarasamy, Dewi Kumara Wati, Moy Siew Fong, Revathy Nallusamy, Azar Kariminia, Annette Sohn
<b>Background.</b> We sought to assess the impact of routine HIV viral load (VL) monitoring on the incidence of switching from a first- to a second-line antiretroviral therapy (ART) regimen, and to describe factors associated with switch. <b>Methods.</b> Data from a regional cohort of 16 clinical programs in 6 Asian countries were analyzed. Second-line switch was defined as a change from a non-nucleoside reverse transcriptase inhibitor (NNRTI) to a protease inhibitor (PI) or vice versa, and >1 of the following: 1) reported treatment failure by local criteria, 2) switch of >1 additional drug, or 3) a preceding HIV viral load (VL) ≥1,000 copies/mL...
October 19, 2016: AIDS Research and Human Retroviruses
Julie Yamaguchi, Catherine A Brennan, Elodie Alessandri, Jean-Christophe Plantier, Gavin Cloherty, Michael G Berg
HIV-2 exhibits a natural history of infection distinct from HIV-1. Primarily found in West Africa and in only 10-20% of HIV infections in this region, patients with HIV-2 typically exhibit a slower progression to AIDS, lower viral loads, and decreased rates of transmission. Here we used next-generation sequencing (NGS) to determine the sequence and phylogenetic classification of 9 HIV-2 genomes. We identified a patient with a series of mutations in an invariant cytotoxic lymphocyte (CTL)-restricted gag epitope required for retroviral structure and replication, and implicated in long-term non-progression to AIDS...
October 19, 2016: AIDS Research and Human Retroviruses
Martin Kuete, HongFang Yuan, Aude Laure Tchoua Kemayou, Emmanuel Ancel Songo, Fan Yang, XiuLan Ma, ChengLiang Xiong, HuiPing Zhang
BACKGROUND: Integration of family planning services (FPS) into human immunodeficiency virus (HIV) care for HIV-infected women is an important aspect of the global prevention of mother-to-child transmission (PMTCT) strategy. We assessed the integration of FPS into routine care of HIV-infected mothers by evaluating the uptake and barriers of contraception and PMTCT services. METHODS: We conducted an interventional study using the interrupted time series approach in the health care facilities located in Yaounde, Cameroon...
2016: Patient Preference and Adherence
Denis R Chopera, Roman Ntale, Nonkululeko Ndabambi, Nigel Garrett, Clive M Gray, David Matten, Quarraisha Abdool Karim, Salim Abdool Karim, Carolyn Williamson
OBJECTIVE: HIV-1 escape from cytotoxic T-lymphocytes (CTL) results in the accumulation of HLA-associated mutations in the viral genome. To understand the contribution of early escape to disease progression, this study investigated the evolution and pathogenic implications of CTL escape in a cohort followed from infection for five years. METHODS: Viral loads and CD4+ counts were monitored in 78 subtype C infected individuals from onset of infection until CD4+ decline to <350 cells/μl or five years post-infection...
October 14, 2016: AIDS
Meng-Hsuan Hsieh, Shu-Chi Wang, Ming-Yen Hsieh, Chung-Feng Huang, Ming-Lun Yeh, Jeng-Fu Yang, Ko Chang, Wei-Ru Lin, Chun-Yu Lin, Tun-Chieh Chen, Jee-Fu Huang, Chia-Yen Dai, Jih-Jin Tsai, Wan-Long Chuang, Ming-Lung Yu
In Taiwan, injecting drug use has been the main route of human immunodeficiency virus (HIV) transmission since 2005, with hepatitis B virus (HBV) and hepatitis D virus (HDV) also having similar transmission routes. This has now become an important public health issue. The aim of this study is to explore the conditions of HDV infections between injecting drug users (IDUs) with and without HIV infection in Southern Taiwan. In this study, 87 IDUs were enrolled, including 27 anti-HDV seronegative IDUs and 60 anti-HDV seropositive IDUs, and the results of their liver function tests, CD4 cell counts, and anti-HIV and HIV RNA levels were analyzed...
October 2016: Kaohsiung Journal of Medical Sciences
Aastha Gupta, Sandeep Juneja, Marco Vitoria, Vincent Habiyambere, Boniface Dongmo Nguimfack, Meg Doherty, Daniel Low-Beer
With anti-retroviral treatment (ART) scale-up set to continue over the next few years it is of key importance that manufacturers and planners in low- and middle-income countries (LMICs) hardest hit by the HIV/AIDS pandemic are able to anticipate and respond to future changes to treatment regimens, generics pipeline and demand, in order to secure continued access to all ARV medicines required. We did a forecast analysis, using secondary WHO and UNAIDS data sources, to estimate the number of people living with HIV (PLHIV) and the market share and demand for a range of new and existing ARV drugs in LMICs up to 2025...
2016: PloS One
J Zhou, W-Y Hu, Y-C Li, H-X Luo, J Li, C-H Li, J-J Tong, C-J Chen, L-L Zhang
OBJECTIVE: We conducted a comparison of the diagnostic kit for quantification of hepatitis B virus DNA (PCR-fluorescence probing) and COBAS TaqMan automated nucleic acid extraction and real-time polymerase chain reaction (PCR) amplification systems. We tested their capacity to quantify and diagnose patients with chronic viral hepatitis B with low viral load < 1 x 103 IU/mL, in hope to provide further evidence for promoting the application of COBAS TaqMan as the diagnostic method for such patients...
September 2016: European Review for Medical and Pharmacological Sciences
Sikhulile Moyo, Terence Mohammed, Kathleen E Wirth, Melanie Prague, Kara Bennett, Molly Pretorius Holme, Lucy Mupfumi, Philemon Sebogodi, Natasha O Moraka, Corretah Boleo, Comfort N Maphorisa, Boitumelo Seraise, Simani Gaseitsiwe, Rosemary M Musonda, Erik van Widenfelt, Kathleen M Powis, Tendani Gaolathe, Eric J Tchetgen Tchetgen, Joseph M Makhema, Max Essex, Shahin Lockman, Vladimir Novitsky
BACKGROUND: Routine monitoring of HIV-1 RNA, or viral load (VL) in patients on antiretroviral therapy (ART) is important, but there are multiple impediments to VL testing in resource-constrained settings. An accurate point-of-care (POC) HIV-1 VL test could alleviate many of these challenges. METHODS: We compared the performance of the Cepheid Xpert® HIV-1 VL against the laboratory-based Abbott m2000sp/m2000rt assay (Abbot assay). ART-naïve individuals participating in the Botswana Combination Prevention Project in 20 communities provided EDTA blood specimens during household surveys...
October 12, 2016: Journal of Clinical Microbiology
Li-Bo Yan, Hui-Ying Rao, Yuan-Ji Ma, Lang Bai, En-Qiang Chen, Ling-Yao Du, Rui-Feng Yang, Lai Wei, Hong Tang
OBJECTIVES: Little is known about hepatitis B virus (HBV) infection in patients with hepatitis C virus (HCV) infection in China. This study aimed to evaluate the prevalence, clinical characteristics, viral interactions and host genotypes of HBV/HCV dual infection compared with HCV monoinfection. STUDY DESIGN: A cross-sectional study. SETTING: China. PARTICIPANTS AND METHODS: 997 patients with HCV from 28 university-affiliated hospitals in China were enrolled in this research...
October 12, 2016: BMJ Open
M L Mzingwane, C T Tiemessen, K L Richter, S H Mayaphi, G Hunt, S M Bowyer
BACKGROUND: Although the use of highly active antiretroviral therapy in HIV positive individuals has proved to be effective in suppressing the virus to below detection limits of commonly used assays, virological failure associated with drug resistance is still a major challenge in some settings. The prevalence and effect of pre-treatment resistance associated variants on virological outcomes may also be underestimated because of reliance on conventional population sequencing data which excludes minority species...
October 12, 2016: Virology Journal
K Sauné, S Raymond, J Boineau, C Pasquier, J Izopet
BACKGROUND: Nucleic acid testing is the major method used to monitor HIV viral load. Commercial systems based on real-time PCR assays are available for high-volume centralized laboratory testing, but they are not fully automated. OBJECTIVES AND STUDY DESIGN: We have compared the diagnostic performance of the Hologic Aptima HIV-1 Quant Dx assay (Aptima) (based on real-time TMA) on the Panther instrument, a fully-automated random access platform, to that of, the Roche Cobas Ampliprep Cobas TaqMan (CAP/CTM) HIV-1 version 2...
October 5, 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Wendy S Armstrong, Jeannette Guarner, Colleen S Kraft, Angela M Caliendo
In this chapter we will discuss the diagnosis and monitoring of individuals with HIV infection. The application and interpretation of these tests does not change dramatically when used in the immunocompromised host. The principal approach to the diagnosis of HIV infection involves serologic testing, although nucleic acid amplification tests play an important role in the diagnosis of acute HIV infection. The algorithm for diagnosis of HIV continues to evolve with newer assays that are able to detect infection within an earlier timeframe after HIV transmission...
August 2016: Microbiology Spectrum
Michael G Ison, Randall T Hayden
Adenoviruses are a highly prevalent infection that can cause a range of clinical syndromes in immunocompromised patients, ranging from localized disease of the respiratory tract, gastrointestinal tract, or urinary tract to disseminated disease. Adenovirus infections may develop in this unique population as the result of primary infection or reactivation of latent virus. Disease can be potentially progressive with high rates of mortality in patients with pneumonia and disseminated disease. Fortunately, cidofovir and its lipid ester, brincidofovir, appear to be effective for the treatment of adenovirus, although neither is specifically approved for this indication...
August 2016: Microbiology Spectrum
Jaime Galindo, Pedro Amariles, Héctor F Mueses-Marín, Jaime A Hincapié, Sebastián González-Avendaño, Ximena Galindo-Orrego
BACKGROUND: Generic drug policies are often associated with concerns about the quality and effectiveness of these products. Phase IV clinical trials may be a suitable design to assess the effectiveness and safety of generic drugs. The objective of this study was to describe the effectiveness and the safety of the generic abacavir/lamivudine and efavirenz in treatment-naïve HIV-infected patients. METHODS: A monocentric, nonrandomized, open-label, phase IV study in treatment naïve HIV-infected patients 18 years or older with indication to receive abacavir/lamivudine and efavirenz were recruited from a program that provides comprehensive outpatient consultation and continuing care...
October 3, 2016: BMC Infectious Diseases
Linh Thuy Nguyen, Emma Gray, Aisling O'Leary, Michael Carr, Cillian F De Gascun
Direct-acting antiviral (DAA) therapies have revolutionised the treatment of hepatitis C virus (HCV). The financial cost of DAAs however is significant, and first generation protease inhibitors (PIs) also require frequent monitoring of viral RNA levels to guide treatment. In this context, we examined the relevance of HCV antigen testing to evaluate the potential role in monitoring virological response to HCV antiviral treatment with the PI-based triple therapies, telaprevir (TVR) and boceprevir (BOC). Chronic HCV-infected individuals (n = 152) enrolled in the Irish Hepatitis C Outcomes Research Network (ICORN) study were prospectively analysed for baseline markers and the early viral kinetics associated with SVR...
2016: PloS One
Yuki Hatayama, Yuki Hashimoto, Ayako Hara, Toru Motokura
BACKGROUND: For patients with reactivation of human cytomegalovirus (CMV), a highly sensitive and accurate CMV quantification system is essential to monitor viral load. METHODS: We constructed a real-time detection PCR (RTD-PCR) system for CMV DNA and evaluated its linearity, lower detection limit, dynamic range and accuracy using two CMV standards. We used 219 clinical samples derived from 101 patients to compare the system with the pp65 antigen test. RESULTS: The 95% detection limit was determined to be 556 IU/mL (95% CI, 440-797 IU/mL), and the quantification range was between 10(2) and 10(6) copies or IU/mL (r = 0...
September 2016: Yonago Acta Medica
Andrew N Phillips, Valentina Cambiano, Fumiyo Nakagawa, Deborah Ford, Tsitsi Apollo, Joseph Murungu, Christine Rousseau, Geoff Garnett, Peter Ehrenkranz, Loveleen Bansi-Matharu, Lara Vojnov, Zachary Katz, Rosanna Peeling, Paul Revill
Point-of-care viral load tests are being developed to monitor patients on antiretroviral therapy (ART) in sub-Saharan Africa. Test design involves trade-offs between test attributes, including accuracy, complexity, robustness, and cost. We used a model of the human immunodeficiency virus epidemic and ART program in Zimbabwe and found that the attributes of a viral load testing approach that are most influential for cost effectiveness are avoidance of a high proportion of failed tests or results not received, use of an approach that best facilitates retention on ART, and the ability to facilitate greater use of differentiated care, including through expanding coverage of testing availability...
September 2016: Open Forum Infectious Diseases
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