Abstract
Background: Currently, there is a global contemplation to end the AIDS epidemic by 2030. HIV-2 poses unique challenges to this end. The burden of HIV-2 is higher in resource-limited countries, and it is intrinsically resistant to NNRTI drugs. In addition, there is no FDA-approved plasma viral load assay to monitor disease progression and therapeutic efficacy. To overcome these challenges, we have developed and evaluated an in-house quantitative HIV-2 viral load assay.
Methods: Blood samples were collected from 28 HIV-2 treatment-naïve monoinfected individuals and tested using an in-house qPCR HIV-2 viral load assay. The extracted RNA was amplified using Quantifast pathogen + IC kit.
Results: The in-house qPCR has a limit of detection of 695 copies/ml. The intra- and inter-assay variation (% CV) of the assay was 0.61 and 0.95, respectively. The in-house assay quantified HIV-2 NIBSC accurately (1000 IU) with a mean of 1952 copies/mL. Among the 28 samples tested by in-house qPCR assay, 11 (39.2%) samples were quantified, whereas 17 (60.7%) samples were not detected. In comparison with Altona RealStar HIV-2 RT PCR and Exavir Load RT assay, the results were 96.4% and 69.6% concordant, respectively. No significant (p = 0.99 and p = 0.13) difference in quantifying viral load between the three assays. Based on clinical and immunological (CD4) staging, the performance characteristics were comparable.
Conclusion: To the best of our knowledge, this is the first in-house qPCR developed in India. The performance characteristics of the in-house assay are comparable to the commercial assays, and they can be used assertively to monitor HIV-2 patients.
Keywords: HIV-1, HIV-2, quantitative real-time polymerase chain reaction, viral load, NNRTI.
Graphical Abstract
[http://dx.doi.org/10.1086/597504] [PMID: 19292644]
[PMID: 8505073]
[http://dx.doi.org/10.1016/0140-6736(91)91333-P] [PMID: 1671908]
[http://dx.doi.org/10.1098/rstb.2010.0031] [PMID: 20643738]
[http://dx.doi.org/10.1073/pnas.0936469100] [PMID: 12743376]
[http://dx.doi.org/10.1038/339389a0] [PMID: 2786147]
[http://dx.doi.org/10.1038/358495a0] [PMID: 1641038]
[http://dx.doi.org/10.1128/jvi.71.5.3953-3960.1997] [PMID: 9094672]
[http://dx.doi.org/10.1128/jvi.70.6.3617-3627.1996] [PMID: 8648696]
[http://dx.doi.org/10.1002/rmv.1739] [PMID: 23444290]
[http://dx.doi.org/10.1186/s12981-019-0239-x] [PMID: 31484562]
[http://dx.doi.org/10.1038/nrmicro1594] [PMID: 17203103]
[http://dx.doi.org/10.3389/fimmu.2017.00580] [PMID: 28588579]
[http://dx.doi.org/10.1186/s12879-019-3743-7] [PMID: 30744575]
[http://dx.doi.org/10.1093/jac/dkx210] [PMID: 29091198]
[http://dx.doi.org/10.1016/S0140-6736(96)04402-9] [PMID: 9093252]
[PMID: 15356940]
[http://dx.doi.org/10.1097/00002030-199411000-00015] [PMID: 7848600]
[http://dx.doi.org/10.1371/journal.pone.0066135] [PMID: 23824279]
[http://dx.doi.org/10.1155/2011/463704] [PMID: 21490779]
[http://dx.doi.org/10.1086/597802] [PMID: 19358668]
[http://dx.doi.org/10.1073/pnas.222366699] [PMID: 12386343]
[http://dx.doi.org/10.1177/135965350400900115] [PMID: 15040537]
[http://dx.doi.org/10.1016/S0140-6736(94)90065-5] [PMID: 7909009]
[http://dx.doi.org/10.1126/science.7915856] [PMID: 7915856]
[http://dx.doi.org/10.1086/339295] [PMID: 11920314]
[http://dx.doi.org/10.1097/COH.0000000000000299] [PMID: 27254747]
[http://dx.doi.org/10.1093/cid/ciq248] [PMID: 21367732]
[http://dx.doi.org/10.1016/S0255-0857(21)02944-3] [PMID: 17642679]
[http://dx.doi.org/10.4103/0971-5916.92627] [PMID: 22310815]
[http://dx.doi.org/10.1086/503258] [PMID: 16586394]
[http://dx.doi.org/10.1186/s12879-019-3781-1] [PMID: 30770728]
[http://dx.doi.org/10.1093/cid/cit733] [PMID: 24218101]
[http://dx.doi.org/10.1086/510073] [PMID: 17143828]
[http://dx.doi.org/10.1001/archinte.160.21.3286] [PMID: 11088091]
[http://dx.doi.org/10.15585/mmwr.mm6903a2] [PMID: 31971928]
[http://dx.doi.org/10.15616/BSL.2016.22.3.83]
[http://dx.doi.org/10.1371/journal.pone.0229424] [PMID: 32109949]
[http://dx.doi.org/10.4103/0974-777X.116872] [PMID: 24049365]
[http://dx.doi.org/10.1186/s12864-018-5152-5] [PMID: 30359242]
[http://dx.doi.org/10.1128/JCM.03691-14] [PMID: 25694533]
[http://dx.doi.org/10.1128/JVI.00604-06] [PMID: 16840312]
[http://dx.doi.org/10.3109/23744235.2015.1122832] [PMID: 26654354]
[http://dx.doi.org/10.1097/QAI.0b013e3181b05f62] [PMID: 19617845]
[http://dx.doi.org/10.2174/1570162053506955] [PMID: 15853722]
[http://dx.doi.org/10.1002/jmv.10492] [PMID: 12966539]
[http://dx.doi.org/10.1111/j.1365-3156.2009.02338.x] [PMID: 19624478]
[http://dx.doi.org/10.1097/QAI.0b013e3181d0db97] [PMID: 20404739]
[http://dx.doi.org/10.1136/bmj.d6792] [PMID: 22074711]
[http://dx.doi.org/10.1093/cid/ciw001] [PMID: 26743094]
[http://dx.doi.org/10.1097/MD.0000000000004886] [PMID: 27631260]
[http://dx.doi.org/10.1016/j.jviromet.2006.02.005] [PMID: 16563526]
[http://dx.doi.org/10.1097/00002030-200003100-00006] [PMID: 10770535]
[http://dx.doi.org/10.1128/JVI.74.3.1554-1557.2000] [PMID: 10627569]
[http://dx.doi.org/10.1002/(SICI)1096-9071(200005)61:1<111:AID-JMV18>3.0.CO;2-W] [PMID: 10745242]
[http://dx.doi.org/10.7448/IAS.17.4.19675] [PMID: 25397425]
[http://dx.doi.org/10.1128/JCM.00724-14] [PMID: 24920771]
[http://dx.doi.org/10.1016/j.jcv.2012.06.024] [PMID: 22832059]
[http://dx.doi.org/10.1128/JCM.00235-17] [PMID: 28515216]
[http://dx.doi.org/10.1371/journal.pone.0129886] [PMID: 26111242]