title: Current challenges to viral load testing in the context of emerging genetic diversity of HIV-1.
abstract: BACKGROUND
  One of the major characteristics of HIV-1 is its extreme genetic diversity. A key factor in assessing the sensitivity of a molecular-based assay measuring HIV-1 RNA viral load (VL) in plasma is its ability to detect/quantify all (or most of) relevant HIV-1 genetic subtype/recombinant forms accurately.
  
  
  METHODS
  This review provides an overview of the current commercially available quantitative real-time assays (the Abbott RealTime HIV-1, Roche TaqMan HIV-1 versions 1.0 and 2.0, BioMérieux Nuclisens EasyQ HIV-1, Siemens VERSANT HIV-1 RNA 1.0 kinetic PCR, and Biocentric Generic HIV Viral Load assays). For each assay, studies from 2005 to 2010 assessing the impact of HIV-1 genetic diversity on the reliability of HIV-1 RNA quantification are described.
  
  
  CONCLUSIONS
  In light of HIV-1 genetic diversity, a general recommendation to favor one test over the other cannot categorically be made. Larger field evaluations of HIV-1 RNA assays should be conducted in areas where HIV-1 genetic diversity is the highest. The large-scale implementation of HIV-1 VL testing is urgently required in the developing world to change HIV infection from a likely death sentence into a manageable chronic infection, as done in Northern countries.
authors.affiliation: Laboratoire de Rétrovirologie, Centre International de Recherches Médicales de Franceville (CIRMF) , BP 769, Franceville, Gabon , France +241 677 092/096 ; +241 677 295 ; franrouet@yahoo.fr.
authors.forename: François
authors.initials: F
authors.lastname: Rouet
authors.forename: Florian
authors.initials: F
authors.lastname: Liégeois
authors.forename: Augustin
authors.initials: A
authors.lastname: Mouinga-Ondémé
authors.forename: Dramane
authors.initials: D
authors.lastname: Kania
authors.forename: Johannes
authors.initials: J
authors.lastname: Viljoen
authors.forename: Sammy
authors.initials: S
authors.lastname: Wambua
authors.forename: Nicole
authors.initials: N
authors.lastname: Ngo-Giang-Huong
authors.forename: Hervé
authors.initials: H
authors.lastname: Ménan
authors.forename: Martine
authors.initials: M
authors.lastname: Peeters
authors.forename: Eric
authors.initials: E
authors.lastname: Nerrienet