Research

Measurement of viral load by the automated Abbott real-time HIV-1 assay using dried blood spots collected and processed in Malawi and Mozambique

Fulvio Erba, Davide Brambilla, Susanna Ceffa, Fausto Ciccacci, Richard Luhanga, Zita Sidumo, Leonardo Palombi, Sandro Mancinelli, Maria Cristina Marazzi, Mauro Andreotti, Marina Giuliano

Abstract


Background. The use of dried blood spots (DBS) for HIV-1 viral load quantification can greatly improve access to viral monitoring for HIV-infected patients receiving treatment in resource-limited settings.

Objectives. To evaluate and validate HIV viral load measurement from DBS in sub-Saharan Africa, with a reliable, all-automated, standard commercial assay such as the Abbott m2000.

Methods. A total of 277 DBS were collected in different health centres in Malawi and Mozambique and analysed for viral load determination using the Abbott m2000 assay with the corresponding plasma samples as gold standard. Samples were extracted using the m2000SP automatic extractor and then processed as the plasma samples using the specific 1.0 mL HIV-RNA DBS protocol.

Results. Among samples with detectable HIV-RNA the correlation between viral load obtained from the paired 131 plasma and DBS samples was high (r=0.946). Overall, viral load values between DBS and plasma differed by less than 0.5 log unit in 90.1% of cases and by less than 1 log unit in 100% of cases. Using a threshold of 1 000 copies/mL (defining virological failure in resource-limited settings), sensitivity was 94.2% and specificity 98.6%, and both positive and negative predictive values were high (98.5% and 94.5%, respectively).

Conclusion. DBS extracted and processed using the Abbott automated system can be reliably used in resource-limited setting to diagnose virological failure.


Authors' affiliations

Fulvio Erba, Department of Clinical Science and Translational Medicine, University of Roma Tor Vergata, Rome, Italy

Davide Brambilla, DREAM Programme, Community of Sant’Egidio, Rome, Italy

Susanna Ceffa, DREAM Programme, Community of Sant’Egidio, Rome, Italy

Fausto Ciccacci, DREAM Programme, Community of Sant’Egidio, Rome, Italy; Department of Infectious Diseases, University of La Sapienza, Rome, Italy

Richard Luhanga, DREAM Programme, Community of Sant’Egidio, DREAM Health Centre, Blantyre, Malawi

Zita Sidumo, DREAM Programme, Community of Sant’Egidio, Centro Para Criança, Maputo, Mozambique

Leonardo Palombi, Department of Biomedicine and Prevention, University of Roma Tor Vergata, Rome, Italy

Sandro Mancinelli, Department of Biomedicine and Prevention, University of Roma Tor Vergata, Rome, Italy

Maria Cristina Marazzi, Department of Community Health, LUMSA University, Rome, Italy

Mauro Andreotti, Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy

Marina Giuliano, Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy

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Keywords

HIV; Viral load; Dried blood spots; Automated Abbott real-time HIV-1 assay; Resource-limited settings

Cite this article

South African Medical Journal 2015;105(12):1036-1038. DOI:10.7196/SAMJ.2015.v105i12.9673

Article History

Date submitted: 2015-04-03
Date published: 2015-11-08

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