Diagnostic testing for HIV type 1 RNA in seronegative blood.
We studied the feasibility of routine diagnostic testing for HIV-1 RNA at a publicly funded testing site. HIV-1 RNA was determined with a commercial polymerase chain reaction assay in pooled seronegative blood samples submitted for HIV testing to a public health laboratory. Recovery of HIV-1 RNA from the samples was estimated as at least 8% of viral RNA that was found in freshly prepared plasma. We estimated that screening for HIV-1 RNA in serum pools would result in the identification of blood specimens from more than 95% of acutely infected patients. The frequency of HIV-1 RNA in seronegative blood samples was estimated to be between 19 and 601 per 10(6) submitted specimens. The ratio of HIV-1 RNA positive and seronegative samples to specimens with HIV-1 antibodies confirmed by Western blot was estimated to be between 0.2% and 6.6%. The reagent costs for identifying 1 HIV-infected blood sample were 10-fold higher with the commercially available HIV-1 RNA assay compared with the HIV antibody enzyme-linked immunosorbent assay. Diagnostic testing for HIV-1 RNA may be warranted in high-risk populations since acutely infected patients may benefit most from anti-retroviral therapy and are thought to contribute disproportionately to the HIV epidemic.
Ritter
D
D
Department of Pathology, St Louis University School of Medicine, MO, USA.
Taylor
J
J
Walkenbach
R
R
Creer
M
M
Arens
M Q
MQ
D015153:Blotting, Western; D004797:Enzyme-Linked Immunosorbent Assay; D005240:Feasibility Studies; D015483:HIV Antibodies / Q000032:analysis; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis*; D018023:HIV Seronegativity; D015497:HIV-1 / Q000235:genetics* / Q000276:immunology; D006801:Humans; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood*
D015483:HIV Antibodies; D012367:RNA, Viral