Skip to main content

Mutations to the probe of Cobas TaqMan HIV-1 ver. 1.0 assay causing undetectable viral load in a patient with acute HIV-1 infection

Abstract

We encountered a human immunodeficiency virus (HIV)-1 in which the viral load was undetectable with the Cobas TaqMan HIV-1 ver. 1.0 (CTM v.1.0) in a patient with acute HIV-1 infection. The CTM v.1.0 assay showed more than 1,000-fold underestimation compared with the subsequent Cobas Amplicor Monitor v.1.5 assay. Because five mismatches to the CTM v.1.0 assay probe in the HIV-1 virus in the patient were disclosed by the manufacturer, partial gag regions of the HIV genome were directly sequenced from the patient’s plasma viral RNA. The detected single nucleotide point mutations were located near the 5′-end of the Cobas Amplicor Monitor probe. Clinicians should be very careful in making interpretations when indeterminate Western blot analysis results and a low or even undetectable HIV-1 viral load are encountered with the CTM HIV-1 ver. 1.0 assay in patients with suspected acute HIV infection. Repeating Western blot analysis is essential before considering a low HIV-1 viral load to be a false-positive result.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. Korn K, Weissbrich B, Henke-Gendo C, Heim A, Mariel Jauer C, Taylor N, et al. Single-point mutations causing more than 100-fold underestimation of human immunodeficiency virus type 1 (HIV-1) load with the Cobas TaqMan HIV-1 real-time PCR assay. J Clin Microbiol. 2009;47:1238–40.

    PubMed  Article  CAS  Google Scholar 

  2. Taylor N, Schmid I, Egle A, Greli R, Patsch W, Oberkofler H. Initial evaluation of the Roche COBAS TaqMan HIV-1 v2.0 assay for determining viral load in HIV-infected individuals. Antivir Ther. 2009;14:1189–93.

    PubMed  Article  CAS  Google Scholar 

  3. Daar ES, Little S, Pitt J, Santangelo J, Ho P, Harawa N, et al. Diagnosis of primary HIV-1 infection. Los Angeles County Primary HIV Infection Recruitment Network. Ann Intern Med. 2001;134:25–9.

    PubMed  CAS  Google Scholar 

  4. Fiebig EW, Heldebrant CM, Smith RI, Conrad AJ, Delwart EL, Busch MP. Intermittent low-level viremia in very early primary HIV-1 infection. J Acquir Immune Defic Syndr. 2005;39:133–7.

    PubMed  Google Scholar 

Download references

Acknowledgments

We are indebted to Mr. Roderick J. Turner, Assistant Professor Edward F. Barroga, and Professor J. Patrick Barron, Chairman of the Department of International Medical Communications at Tokyo Medical University, for their review of the English manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mihoko Yotsumoto.

About this article

Cite this article

Yotsumoto, M., Shinozawa, K., Yamamoto, Y. et al. Mutations to the probe of Cobas TaqMan HIV-1 ver. 1.0 assay causing undetectable viral load in a patient with acute HIV-1 infection. J Infect Chemother 17, 863–865 (2011). https://doi.org/10.1007/s10156-011-0263-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10156-011-0263-9

Keywords

  • TaqMan HIV-1 real-time PCR assay
  • Acute HIV-1 infection
  • Mutations to the probe
  • Undetectable HIV-1 viral load