Fiscus SA, Shepard R, Schock J, Robertson K, Shugars D, Dyer J, Cohen MS, Vernazza PL; Conference on Retroviruses and Opportunistic Infections.
Program Abstr 6th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 6th 1999 Chic Ill. 1999 Jan 31-Feb 4; 6th: 124 (abstract no. 295).
University of North Carolina, Chapel Hill.
Antiretroviral therapy (ART) can reduce HIV viral load (VL) to varying degrees in blood. However, little is known about the effects of therapy on other compartments and few comparative studies have been done to determine the optimal method for measuring VL in fluids other than blood plasma (BP). We compared two commercially available RNA techniques (Organon-Teknika's NASBA and Roche's RT-PCR) for quantitating HIV-1 RNA from cerbral spinal fluid (CSF), saliva (SAL), breast milk (BM), seminal plasma (SP), and cervical-vaginal lavage (CVL). At first, fluids from HIV-seronegatives spiked with HIV were tested. SP, BM and SAL frequently demonstrated inhibition in RT-PCR, as evidenced by the use of the first QS well for calculating VL (SP-24/25, BM-4/9; SAL-4/6 inhibited). Inhibition of RT-PCR was not observed with CSF (5/5) or CVL (5/5), nor in any of NASBA assays. When fluids from infected patients were tested in both assays, RT-PCR: CSF-8/11, BM-3/5, SP-14/25, CVL-1/1 had detectable RNA; NASBA: CSF-3/11, BM-2/5, SP-17/25, and CVL-0/1 specimens had detectable RNA. Differences between techniques were largely attributable to increased sensitivity of the RT-PCR assay at lower VL. In cross-sectional studies RT-PCR was used to measure paired BP and CSF: BP-72/101 (71%+), CSF-42/102 (42%+). NASBA was used with paired BP and CVL, SAL, and SP: BP-129/142 (91%+) and CVL-77/144 (55%+); BP-18/18 (100%+) and SAL-10/18(56%+); BP-96/116 (83%+) and SP-101/161 (63%+). In longitudinal studies following initiation of new ART, changes in SP (n=73) and CVL (n=51) VL fell in parallel with VL changes in blood. NASBA worked fairly well to quantitate HIV-1 RNA from all fluids without apparent inhibition. RT-PCR performed well on CVL and CSF, usually with greater sensitivity, but its use in other fluids appears limited due to the presence of inhibitors. VL is usually lower in non-blood fluids and ART decreases VL in the genital tract much as it does in blood.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Body Fluids
- Cross-Sectional Studies
- Female
- HIV Infections
- HIV Seropositivity
- Humans
- Longitudinal Studies
- Milk, Human
- RNA
- RNA, Viral
- Reverse Transcriptase Polymerase Chain Reaction
- Saliva
- Self-Sustained Sequence Replication
- Semen
- Sensitivity and Specificity
Other ID:
UI: 102188941
From Meeting Abstracts