Isothermal Amplification with a Target-Mimicking Internal Control and Quantitative Lateral Flow Readout for Rapid HIV Viral Load Testing in Low-Resource Settings

The tiered laboratory framework for HIV viral load monitoring accommodates a range of HIV viral load testing platforms, with quality assessment critical to ensure quality patient testing. HIV plasma viral load testing is challenged by the instability of viral RNA. An approach using an RNA stabilizing buffer is described for the Xpert HIV-1 Viral Load (Cepheid) assay and was tested in remote laboratories in South Africa. EDTA-plasma panels with known HIV viral titres was prepared in PrimeStore molecular transport medium for per-module verification and per-instrument external quality assessment. The panels were transported at ambient temperature to 13 testing laboratories during 2017-2018, tested according to standard procedures and uploaded to a web portal for analysis A total of 275 quality assessment specimens (57 verification panels and two EQA cycles) were tested. All participants passed verification (n=171 specimens) with an overall concordance correlation (ρc) of 0.997 (95%confidence interval [CI]:0.996,0.998) and a mean log bias of -0.019log cp/mL (95%CI:-0.044,0.063). The overall EQA ρc (n=104 specimens) was 0.999 (95%CI:0.998,0.999), with a mean log bias of 0.03 log cp/mL 95%(CI:0.02,0.05). The panels are suitable for use in quality monitoring of Xpert HIV-1 VL and are applicable to laboratories in remote settings.

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Economic and public health impact of decentralized HIV viral load testing: A modelling study in Kenya

PLoS ONE ◽

10.1371/journal.pone.0212972 ◽

2019 ◽

Vol 14 (2) ◽

pp. e0212972 ◽

Cited By ~ 2

Author(s):

M. de Necker ◽

J. C. de Beer ◽

M. P. Stander ◽

C. D. Connell ◽

D. Mwai

Keyword(s):

Public Health ◽

Viral Load ◽

Health Impact ◽

Public Health Impact ◽

Load Testing ◽

Hiv Viral Load ◽

Viral Load Testing ◽

Modelling Study

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Specimen origin, type and testing laboratory are linked to longer turnaround times for HIV viral load testing in Malawi

PLoS ONE ◽

10.1371/journal.pone.0173009 ◽

2017 ◽

Vol 12 (2) ◽

pp. e0173009 ◽

Cited By ~ 12

Author(s):

Peter A. Minchella ◽

Geoffrey Chipungu ◽

Andrea A. Kim ◽

Abdoulaye Sarr ◽

Hammad Ali ◽

...

Keyword(s):

Viral Load ◽

Load Testing ◽

Hiv Viral Load ◽

Testing Laboratory ◽

Viral Load Testing

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Concurrent COVID-19 and Acute HIV: A Case Report and Diagnostic Review

Case Reports in Medicine ◽

10.1155/2021/2653678 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Kelly A. Johnson ◽

Sally Graglia ◽

Elizabeth D. Lynch ◽

Joanna De Mesa ◽

Erin Antunez ◽

...

Keyword(s):

Viral Load ◽

Antibody Test ◽

Fourth Generation ◽

Load Testing ◽

Test Results ◽

Hiv Viral Load ◽

Sexually Transmitted ◽

Viral Load Testing ◽

Hiv Test ◽

Acute Hiv

A 26-year-old male presented to the emergency department feeling unwell in February of 2021 with symptoms including diaphoresis, loose stools, and loss of taste sensation. Workup not only confirmed a diagnosis of COVID-19 but also revealed discordant HIV test results, with a reactive fourth-generation antigen/antibody test but a negative HIV-1/2 differentiation immunoassay. Subsequent HIV viral load testing obtained two days later ultimately established a diagnosis of acute HIV (AHI). Screening for HIV and other sexually transmitted infections decreased during the COVID-19 pandemic. It is critical that providers (1) continue recommended screening for HIV as an essential service; (2) consider acute HIV in the differential when evaluating patients with acute viral syndromes; (3) recognize that AHI can occur concurrently with other infections, including COVID-19; and (4) understand the differential diagnosis for discordant HIV test results and know when HIV viral load testing is needed to resolve such discordant results.

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