Conclusions-HCV RNA levels at three months after transplant are higher in patients treated with single initial immunosuppressive therapy, but at 12 months are higher in patients with longer duration of steroid treatment. HCV viraemia at 12 months seems to be particularly important, as its levels are strongly correlated with the severity of fibrosis. (Gut 1999;45:427-434)

In resource-limited settings, the virological monitoring of antiretroviral therapy is limited by high cost and the lack of infrastructure. The Cavidi ExaVir Load assay employs a simple and inexpensive enzyme-linked immunosorbent assay format to measure human immunodeficiency virus (HIV) reverse transcriptase activity, which correlates with plasma RNA load. The version 3 assay has been described as having improved precision and sensitivity. There are limited data on its performance relative to those of current real-time assays

The performance of the new Abbott real-time human immunodeficiency virus type 1 (HIV-1) assay for HIV-1 RNA load determination in plasma was compared to that of the Abbott LCx HIV-1 RNA quantitative assay following automated RNA isolation by the Abbott m1000 extractor. The measured viral loads of 89 clinical specimens differed by mean 0.19 log 10 copies/ml (95% confidence interval, 0.12 to 0.26 log 10 copies/ml). Although the difference in viral load determinations was positively skewed in favor of the LCx assay, it did not reach statistical significance (P ‫؍‬ 0.42). Results were linearly associated (R 2 ‫؍‬ 0.94) and strongly correlated (R ‫؍‬ 0.96). Good performance was observed with HIV-1 subtypes other than B and circulating recombinant forms, although results obtained with two subtype G specimens and one H specimen showed a more substantial difference.Since its introduction in the 1990s, measurement of plasma viral load (PVL) has become a cornerstone in the clinical management of human immunodeficiency virus type 1 (HIV-1) infection. The central role played by PVL has considerably increased laboratory workload, making necessary an improvement in technology. A variety of commercial assays are available for the measurement of HIV-1 PVL. Among them, realtime PCR is the latest development, offering many advantages over traditional molecular methods (3, 7, 11). These include (i) decreased performance time attributed to reduced cycle time, reduced amplicon size, and the elimination of an additional step needed for product detection; (ii) increased sensitivity as a result of the employment of fluorescence detection methods; (iii) decreased carryover contamination due to the use of a close system for the amplification and detection; and (iv) wider dynamic range. Further enhancements have been achieved by the introduction of automated nucleic acid extractions, resulting in completely automated assays with an average turnaround time of 2 h.The objective of this study was to evaluate the performance of the new Abbott real-time HIV-1 assay (referred to as the realtime assay) for PVL quantitation in comparison with the Abbott LCx HIV-1 RNA quantitative assay (referred to as the LCx assay). Both assays target the integrase region of the HIV-1 genome. In the LCx assay, 24 samples can be processed in one run, including 21 clinical specimens and 3 controls. The range of quantification is from 50 to 1 million copies/ml. In the real-time assay, 48 samples can be processed in one run. The range of quantification is 40 to 10 million copies/ml. Previous studies have assessed the performance of the LCx assay and found the test suitable for the management of patients infected by HIV-1 group M subtypes (1, 4, 8, 9). MATERIALS AND METHODSPatient and samples. Samples were randomly collected from 92 HIV-1-seropositive patients attending the Ian Charleson Day Centre clinic at Royal Free Hospital in London. Plasma was prepared from EDTA-anticoagulated blood and frozen at Ϫ80°C within 6 h of collection.Viral load determination. Plasma R...

Background-The extent to which the prognosis for AIDS and death of patients initiating highly active antiretroviral therapy (HAART) continues to be affected by their characteristics at the time of initiation (baseline) is unclear.Methods-We analyzed data on 20,379 treatment-naive HIV-1-infected adults who started HAART in 1 of 12 cohort studies in Europe and North America (61,798 person-years of followup, 1844 AIDS events, and 1005 deaths).Results-Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count <25 cells/µL had persistently higher progression rates than individuals with a baseline CD4 count >350 cells/µL (hazard ratio for AIDS = 2.3, 95% confidence interval [CI]: 1.0 to 2.3; mortality hazard ratio = 2.5, 95% CI: 1.2 to 5.5, 4 to 6 years after starting HAART). Rates of AIDS were persistently higher in individuals who had experienced an AIDS event before starting HAART. Individuals with presumed transmission by means of injection drug use experienced substantially higher rates of AIDS and death than other individuals throughout follow-up (AIDS hazard ratio = 1.6, 95% CI: 0.8 to 3.0; mortality hazard ratio = 3.5, 95% CI: 2.2 to 5.5, 4 to 6 years after starting HAART).Conclusions-Compared with other patient groups, injection drug users and patients with advanced immunodeficiency at baseline experience substantially increased rates of AIDS and death up to 6 years after starting HAART.

No abstract