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J Med Microbiol 56 (2007), 1611-1614; DOI: 10.1099/jmm.0.47456-0
© 2007 Society for General Microbiology
ISSN 1473-5644

Use of an HIV-1 reverse-transcriptase enzyme-activity assay to measure HIV-1 viral load as a potential alternative to nucleic acid-based assay for monitoring antiretroviral therapy in resource-limited settings

H. Syed Iqbal1, P. Balakrishnan1, Anitha J. Cecelia1, Suniti Solomon1, N. Kumarasamy1, Vidya Madhavan1, K. G. Murugavel1, Aylur K. Ganesh1, Sunil Suhas Solomon1, Kenneth H. Mayer2 and Suzanne M. Crowe3

1 YRG Centre for AIDS Research and Education (YRG CARE), Voluntary Health Services Hospital Campus, Taramani, Chennai-600113, India

2 Brown University/Miriam Hospital, Providence, RI, USA

3 Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia

Correspondence
P. Balakrishnan
bala{at}yrgcare.org

Received 18 June 2007
Accepted 27 August 2007

An inexpensive and technically less-demanding methodology to quantify HIV-1 viral load would be of great value for resource-limited settings, where the nucleic-acid amplification technique (NAAT) is impractical and/or resource-prohibitive. In this study, an HIV-1 reverse-transcriptase enzyme-activity assay (ExaVir Load assay, version 1) was compared with the gold standard RT-PCR assay, Roche HIV-1 Amplicor Monitor, version 1.5. A total of 121 plasma specimens were used for the evaluation. ExaVir Load had a sensitivity of 97 % and a specificity of 71 % in identifying specimens with <400 copies ml–1 in the Roche RT-PCR assay as being less than the detection limit of the assay (5500 copies ml–1). The mean difference (95 % limits of agreement) between Roche RT-PCR and ExaVir Load was –0.23 (–1.59 to 1.13) log10(copies ml–1) by Bland–Altman analysis. Significant negative correlations were seen between CD4+ T-cell counts and the ExaVir Load assay (r=–0.32, P<0.05), and between CD4+ T-cell counts and the Roche RT-PCR (r=–0.38, P<0.01). The present study with HIV-1 showed a strong correlation between the ExaVir Load assay and the RT-PCR assay. Hence, the ExaVir Load assay could be considered for use in resource-limited settings as an alternative viral-load assay to the standard NAAT-based assay after further evaluation with prospective specimens.

Abbreviations: ART, antiretroviral therapy; IQR, interquartile range; NAAT, nucleic-acid amplification technique; PVL, plasma viral load, RT, reverse transcriptase.






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