Subtype variability, virological response and drug resistance assessed on dried blood spots collected from HIV patients on antiretroviral therapy in Angola

Garrido, Carolina; Zahonero, Natalia; Fernándes, Diana; Serrano, Dulcelina; Silva, Ana Rita; Ferraria, Nelia; Antúnes, Francisco; González-Lahoz, Juan; Soriano, Vincent; Mendoza, Carmen de

doi:10.1093/jac/dkm515

Cited by 52 publications

(47 citation statements)

References 10 publications

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“…Good responses to HAART have been reported from developing countries where a variety of virus strains circulates, but comparisons of individual subtypes remain scarce [25][26][27]. Studies from western Europe and North America previously compared responses to HAART in patients with subtype B and non-B subtypes grouped together and suggested similar virologic outcomes during up to 24 months of therapy [15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Effect of HIV‐1 Subtype on Virologic and Immunologic Response to Starting Highly Active Antiretroviral Therapy

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Effect of HIV‐1 Subtype on Virologic and Immunologic Response to Starting Highly Active Antiretroviral Therapy

et al. 2009

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“…DBS can be easily collected and stored without being frozen or refrigerated (2,17,22). Several studies have demonstrated the feasibility of DBS as a specimen type for VL testing using different methodologies, although limitations in terms of sensitivity and stability have been noted (3,5,9,10,12,16). In addition, the recognition of distinct subtypes is an important problem in countries where HIV variability is high, and some VL assays occasionally underquantify some variants (19,24).…”

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confidence: 99%

Comparison of HIV-1 RNA Measurements Obtained by Using Plasma and Dried Blood Spots in the Automated Abbott Real-Time Viral Load Assay

Arredondo¹,

Garrido²,

Parkin

et al. 2012

J Clin Microbiol

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c Dried blood spots (DBS) may be a promising alternative specimen type to plasma for measuring the viral load (VL) in HIVinfected individuals in resource-limited settings. However, characterization of assay performance using DBS is incomplete. In this prospective study, the VL was measured in parallel using plasma and DBS specimens collected at the same time from 157 HIV-1-infected individuals. DBS were prepared by dispensing 50 l of blood onto filter paper cards and were stored desiccated at ؊20°C. Nucleic acid extraction from plasma and DBS was performed automatically using the Abbott m2000sp instrument, and the VL was measured using the RealTime HIV-1 VL assay, which has a lower limit of detection of 40 HIV RNA copies/ml. The correlation between plasma and DBS results was good (R ‫؍‬ 0.91; P < 0.001). The mean difference in the VL (DBS minus plasma) was 0.35 log copies (standard deviation [SD], 0.47 log copies). A total of 40 (26%) paired specimens had a difference of >0.5 log copy, and in 12 (7.8%) it was >1 log copy. the VL from DBS was measurable in 95.7% of specimens with a plasma VL of >2.74 log copies (550 HIV RNA copies/ml). In summary, the VL can reliably be measured using DBS with the Abbott RealTime HIV-1 assay. The estimated lower limit of detection of this automated methodology on DBS is 550 copies/ml, a threshold that may be acceptable for periodic VL monitoring in patients on antiretroviral therapy in resource-limited settings, where early detection of virologic treatment failure is often problematic. P eriodic measurement of the viral load (VL) in plasma remains a key parameter in the follow-up of HIV-infected individuals, especially those on antiretroviral therapy (ART) (21). However, reliable VL testing in plasma requires specialized facilities that often are not available in resource-poor settings. Dried blood spots (DBS) may be an interesting alternative to plasma for periodic VL testing (1,5,7,9,12,23). DBS can be easily collected and stored without being frozen or refrigerated (2,17,22). Several studies have demonstrated the feasibility of DBS as a specimen type for VL testing using different methodologies, although limitations in terms of sensitivity and stability have been noted (3,5,9,10,12,16). In addition, the recognition of distinct subtypes is an important problem in countries where HIV variability is high, and some VL assays occasionally underquantify some variants (19,24).In a previous study, we reported the results of VL testing on DBS using the Abbott mSample preparation system, a manual RNA isolation method. Although the correlation with plasma values was acceptable, the sensitivity was significantly lower on DBS (ϳ3.5 log copies) (11). Improvements in the detection limit (similar to plasma values of ϳ400 copies/ml) are important for early recognition of virological failure in patients on antiretroviral treatment. Here, we evaluate the feasibility of using an automated RNA isolation method, m2000sp, and the Abbott RealTime HIV-1 VL assay to quantify HIV-1 RNA on DBS and compar...

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“…These mutations are among the most common transmitted drug resistance mutations reported worldwide (9,13,(17)(18)(19). These two isolates should not be fully sensitive to the standard firstline antiretroviral regimens currently used in Angola and most other resource-limited settings (8,10,23). According to the WHO criteria (5), Angola has a low prevalence of transmitted resistance that is similar to the levels for other Sub-Saharan African countries where ART is still not widely available (1,6,9,12,15,20,22).…”

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Antiretroviral Drug Resistance Surveillance among Treatment-Naive Human Immunodeficiency Virus Type 1-Infected Individuals in Angola: Evidence for Low Level of Transmitted Drug Resistance

Bártolo

Rocha

Bartolomeu³

et al. 2009

Antimicrob Agents Chemother

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The prevalence of transmitted human immunodeficiency virus type 1 drug resistance in Angola in 2001 in 196 untreated patients was investigated. All subtypes were detected, along with unclassifiable and complex recombinant strains. Numerous new polymorphisms were identified in the reverse transcriptase and protease. Two (1.6%) unrelated patients harbored nucleoside reverse transcriptase inhibitor-and nonnucleoside reverse transcriptase inhibitor-resistant viruses (mutations: M41L, D67N, M184V, L210W, T215Y or T215F, and K103N). Continued surveillance of drug resistance is required for maximization of ART efficacy in Angola.

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Subtype variability, virological response and drug resistance assessed on dried blood spots collected from HIV patients on antiretroviral therapy in Angola

Cited by 52 publications

References 10 publications

Effect of HIV‐1 Subtype on Virologic and Immunologic Response to Starting Highly Active Antiretroviral Therapy

Effect of HIV‐1 Subtype on Virologic and Immunologic Response to Starting Highly Active Antiretroviral Therapy

Comparison of HIV-1 RNA Measurements Obtained by Using Plasma and Dried Blood Spots in the Automated Abbott Real-Time Viral Load Assay

Antiretroviral Drug Resistance Surveillance among Treatment-Naive Human Immunodeficiency Virus Type 1-Infected Individuals in Angola: Evidence for Low Level of Transmitted Drug Resistance

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