HIV Viral Load Monitoring

  • Douglas Richman
  • Suzanne Crowe
  • Katya Harvey
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 458)

Abstract

Markers of HIV infection are used in the clinical setting to predict prognosis in HIV-infected persons, measure disease progression and monitor responses to therapy. In the past, the most commonly used tests were CD4 cell counts and serum p24 antigen levels, although serum beta-2 microglobulin, serum neopterin, serum IgA levels and CD8 cell numbers were used as adjunctive measures by some clinicians. Since the early to mid 1990s new technologies for the detection of HIV RNA in human plasma have allowed relatively accurate and precise measurement of plasma HIV RNA concentrations, which directly relate to the production of HIV-1 in tissues, particularly the lymphoid tissues. The available assays to quantify plasma HIV RNA, in combination with CD4 counts, enable clinicians to monitor responses to antiretroviral therapy and to predict the risk for disease progression.1,2,3,4

Keywords

Dioxide EDTA Titration Dementia Heparin 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Mellors JW, Rinaldo Jr CR, Gupta P, et al. Prognosis in HIV-1 infection predicted by the quantity of virus in plasma. Science. 1996; 272: 1167–1170.PubMedCrossRefGoogle Scholar
  2. 2.
    Coombs RW, Welles SL, Hooper C, et al. Association of plasma human immunodeficiency virus type 1 RA level with risk of clinical progression in patients with advanced infection. J Infect Dis. 1996; 174: 704–712.PubMedCrossRefGoogle Scholar
  3. 3.
    Saag MS, Holondniy M, Kuritzkes DR, et al. HIV viral load markers in clinical practice. Nature Medicine. 1996; 2: 625–629.PubMedCrossRefGoogle Scholar
  4. 4.
    Mellors JW, Munoz A, Giorgi JV, et al. Plasma viral load and CD4+ lymphocytes as prognostic markers of HV-1 infection. Ann Intern Med. 1997; 126: 946–954.PubMedGoogle Scholar
  5. 5.
    Longo MC, Berininger MS, Hartley JL. Use of uracil DNA glycosylase to control carry-over contamination in Polymerase chain reactions. Gene. 1990; 93: 125–128.PubMedCrossRefGoogle Scholar
  6. 6.
    Holodiny M, Katzenstein DA, Israelski DM, et al. Reduction in plasma human immunodeficiency virus ri-bonucleic acid following dideoxynucleoside therapy as determined by the Polymerase chain reaction. J Clin Invest. 1991; 88: 1755–1759.CrossRefGoogle Scholar
  7. 7.
    Steiger M, Demolliere C, Ahlborn-Laake L, et al. Competitive Polymerase chain reaction assay for quanti-tation of HIV-1 DNA and RNA. J Virol Methods. 1991; 34: 149–160.CrossRefGoogle Scholar
  8. 8.
    Sninsky JJ, Kwok S (1993). The application of quantitative Polymerase chain reaction to therapeutic monitoring. AIDS. 7: S29.PubMedCrossRefGoogle Scholar
  9. 9.
    Mulder J, McKinney N, Christopherson C, et al. Rapid and simple PCR assay for quantitation of human immunodeficiency virus type 1 RNA in plasma; application to acute retroviral infection. J Clin Microbiol. 1994; 32: 292–300.PubMedGoogle Scholar
  10. 10.
    Revets H, Marissens D, De Wit S, et al. Comparitive Evaluation of NASBA HIV-1 RNAQT, AMPLICOR-HIV Monitor, and QUANTIPLEX HIV RNA Assay, Three methods for quantification of human Immunodeficiency virus type 1 RNA in plasma. J Clin Microbiol. 1996; 34: 1058–1064.PubMedGoogle Scholar
  11. 11.
    Mulder J, McKinney N, Kwok S (1996). A rapid and simple sample preparation method dramatically increases sensitivity of HIV-1 plasma RNA assay. Abstract.Th.B.914. XI International Conference on AIDS; Vancouver.Google Scholar
  12. 12.
    Michael N, Robb M, Birx D, et al., (1997). Performance of the amplicor HIV-1 monitorTM test and a modified HIV-1 monitor test on HIV-1 subtypes A to F. Abstract. 4th Conference on Retroviruses and Opportunistic Infections, Washington DC.Google Scholar
  13. 13.
    Urdea MS, Wilber JC, Yeghiazarian T, et al. Direct and quantitative detection of HIV-1 RNA in human plasma with branched DNA signal amplification assay. AIDS. 1993; 7: S11–S14.PubMedCrossRefGoogle Scholar
  14. 14.
    Todd J, Pachl C, White R, et al. Performance characteristics for the quantitation of plasma HIV-1 RNA using branched DNA signal amplification technology. J Acquir Immune Defic Syndr Hum Retroviral. 1995; 10: S35.Google Scholar
  15. 15.
    Kern D, Collins M, Fultz T, et al. An enhanced sensitivity branched DNA (ES bDNA) assay for the quantification of HIV-1 RNA in plasma. J Clin Micro. 1996; 34: 3196–3202.Google Scholar
  16. 16.
    Dunne A, Janky S, Crowe S. Signal Amplification: A Direct Approach to Viral Quantitation. Today’ s Life Science. 1995; 7: 48–53.Google Scholar
  17. 17.
    Deeks SG, Coleman RL, White R, et al. Variance of plasma human immunodeficiency virus type 1 RNA levels measured by branched DNA within and between days. J Infect Dis. 1997; 176: 514–517.PubMedCrossRefGoogle Scholar
  18. 18.
    Mellors JW, Munoz A, Giorgi JV, et al. Plasma viral load and CD4+ lymphocytes as prognostic markers of HIV-1 infection. Ann Intern Med 1997; 126: 946–954.PubMedGoogle Scholar
  19. 19.
    Collins ML, Irvine B, Tyner D, et al. A branched DNA signal amplification assay for quantification of nucleic acid targets below 100 molecules/ml. Nucleic Acids Res. 1997; 25: 2979–2984.PubMedCrossRefGoogle Scholar
  20. 20.
    Compton J. Nucleic acid sequence based amplification. Nature (London). 1991; 350: 91–92.CrossRefGoogle Scholar
  21. 21.
    Romano JW, Williams KG, Shurtliff RN, et al. NASBA technology: isothermal RNA amplification in qualitative and quantitative diagnostics. Immunol Invest. 1997; 26: 15–28.PubMedCrossRefGoogle Scholar
  22. 22.
    van Gemen B, van Beuningen R, Nabbe A. A one tube quantitative HIV-1 RNA NASBA nucleic acid amplification assay using electrochemiluminescent (ECL) labelled probes. J Virologic Methods. 1994; 49: 157–168.CrossRefGoogle Scholar
  23. 23.
    Schuurman R, Descamps D, Weverling GJ, et al. Multicenter comparison of three commercial methods for quantification of human immunodeficiency virus type 1 RNA in plasma. J Clin Microbiol. 1996; 34: 3016–3022.PubMedGoogle Scholar
  24. 24.
    Dewar R, Highbarger H, Sarmiento MD, et al. Application of branched DNA signal amplification to monitor human immunodeficiency virus type 1 burden in human plasma. J Infect Dis. 1994; 170: 1172–1179.PubMedCrossRefGoogle Scholar
  25. 25.
    Raboud JM, Montaner JSG, Conway B, et al. Variation in plasma RNA levels, CD4 cell counts, and p24 antigen levels in clinically stable men with human immunodeficiency virus infection. J Infect Dis. 1996; 174: 191–194.PubMedCrossRefGoogle Scholar
  26. 26.
    Izopet J, Poggi C, Dussaix E, et al. Assessment of a standardized reverse transcriptase PCR assay for quantifying HIV-1 RNA in plasma and serum. J Virologic Methods. 1996; 60: 119–129.CrossRefGoogle Scholar
  27. 27.
    Schockmel GA, Yerly S, Perrin L. Detection of low HIV-1 RNA levels in plasma. J Acq Immune Defic Syndr Hum Retrovir. 1997; 14: 179–183.CrossRefGoogle Scholar
  28. 28.
    Coste J, Montes B, Reynes J, et al. Comparative evaluation of three assays for the quantitation of human immunodeficiency virus type 1 RNA in plasma. J Med Virol. 1996; 50: 293–302.PubMedCrossRefGoogle Scholar
  29. 29.
    Ercoli L, Sarmati L, Es-Sawaf G, et al. Plasma viremia titration and RNA quantitation in ICD-p24 negative HIV type-1 infected patients. AIDS Res Hum Retrovir. 1995; 11: 1203–1207.PubMedCrossRefGoogle Scholar
  30. 30.
    Schupbach J, Boni J, Tomasik Z, et al. Sensitive detection and early prognostic significance of p24 antigen in heat denatured plasma of human immunodeficiency virus type 1 infected infants. J Infect Dis. 1994; 170: 318–324.PubMedCrossRefGoogle Scholar
  31. 31.
    Boni J, Opravil M, Tomasik Z, et al. Simple monitoring of antiretroviral therapy with a signal amplification boosted HIV-1 p24 antigen assay with heat denatured plasma. AIDS. 1997; 11: 47.CrossRefGoogle Scholar
  32. 32.
    Cao Y, Ho DD, Todd J, et al. Clinical evaluation of branched DNA signal amplification for quantifying HIV type 1 in human plasma. AIDS Res Hum Retrovir. 1995; 11: 353–361.PubMedCrossRefGoogle Scholar
  33. 33.
    Pachl C, Todd JA, Kern DG, et al. Rapid and precise quantification of HIV-1 RNA in plasma with use of a branched DNA signal amplification assay. J AIDS. 1995; 5: 446–454.Google Scholar
  34. 34.
    Paxton WB, Coombs RW, McElrath MJ, et al. Longitudinal analysis of quantitative virologie measures in human immunodeficiency virus-infected subjects with ≥ 400 CD4 lymphocytes; implications for applying measurements to individual patients. National Institute of Allergy & Infect Diseases AIDS Vaccine Evaluation Group. J Infect Dis. 1997; 175: 247–254.PubMedCrossRefGoogle Scholar
  35. 35.
    Holodniy M, Mole L, Winters M, et al. Diurnal and short term stability of HIV virus load as measured by gene amplification. J Acq Imm Def Syndr. 1994; 7: 363–368.Google Scholar
  36. 36.
    Bruisten SM, Oudshoorn P, van Swieten P, et al. (1997). Stability of HIV-1 RNA in blood during specimen handling and storage prior to amplification by NASBA-QT. J Virol Methods. 67: 199–207.PubMedCrossRefGoogle Scholar
  37. 37.
    Holodniy M, Mole L, Yen-Lieberman B, et al. Comparative stabilities of quantitative human immunodeficiency virus RNA in plasma from samples collected in VACUTAINER CPT, VACUTAINER PPT, and standard VACUTAINER tubes. J Clin Microbiol. 1995; 33: 15620–15666.Google Scholar
  38. 38.
    Winters M, Tan L, Katzenstein D, et al. Biological variation and quality control of plasma human immunodeficiency virus type 1 RNA quantitation by reverse transcriptase Polymerase chain reaction. J Clin Microbiol. 1993; 31: 2960–2966.PubMedGoogle Scholar
  39. 39.
    Ioannidis JPA, Cappelleri JC, Lau J, et al. Predictive value of viral load measurements in asymptomatic untreated HIV-1 infection; a mathematical model. AIDS. 1996; 10: 255–262.PubMedCrossRefGoogle Scholar
  40. 40.
    Dunne A, and Crowe S. Comparison of branched DNA and reverse transcriptase polymerase chain reaction for quantifying six different HIV-1 subtypes in plasma. AIDS. 1997; 11: 126–127.PubMedCrossRefGoogle Scholar
  41. 41.
    Gobbers E, Fransen K, Oosterlaken T, et al. Reactivity and amplification efficiency of the NASBA HIV-1 RNA amplification system with regard to different HIV-1 subtypes. J Virologic Methods. 1997; 66: 293–301.CrossRefGoogle Scholar
  42. 42.
    Alaeus A, Lidman K, Sonnerborg A, et al. Subtype-specific problems with quantification of plasma HIV-1 RNA. AIDS. 1997; 11: 859–865.PubMedCrossRefGoogle Scholar
  43. 43.
    Brew B, Pemberton L, Cunningham P (1996). Abstract WeB 3287. Cerebrospinal fluid HIV-1 RNA levels correlate with AIDS dementia complex. XI International Conference on AIDS, Vancouver.Google Scholar
  44. 44.
    Dyer JR, Gilliam BL, Eron JJ, et al. Quantitation of human immunodeficiency virus type 1 RNA in cell free seminal plasma; comparison of NASBA with Amplicor reverse transcription PCR amplification and correlation with quantitative culture. J Virol Methods. 1996; 60: 161–170.PubMedCrossRefGoogle Scholar
  45. 45.
    Gupta P, Mellors J, Kingsley L, et al. High viral load in semen of human immunodeficiency virus type 1 infected men at all stages of disease and its reduction by therapy with protease and nonnucleoside reverse transcriptase inhibitors. J Virol. 1997; 71: 6271–6275.PubMedGoogle Scholar
  46. 46.
    Mellors JW, Munoz A, Giorgi JV, et al. Plasma viral load and CD4+ lymphocytes as prognostic markers of HIV-1 infection. Ann Intern Med 1997; 126: 946–954.PubMedGoogle Scholar
  47. 47.
    Coombs RW, Welles SL, Hooper C, et al. Association of plasma human immunodeficiency virus type-1 RNA level with risk of clinical progression in patients with advanced infection. J Infect Dis 1996; 174: 704–712.PubMedCrossRefGoogle Scholar
  48. 48.
    Welles SL, Jackson JB, Yen-Lieberman B, et al. Prognostic value of plasma Human Immunodeficiency Virus Type 1 (HIV-1) RNA levels in patients with advanced HIV-1 disease and with little or no prior zi-dovudine therapy. J Infect Dis 1996; 174: 696–703.PubMedCrossRefGoogle Scholar
  49. 49.
    Katzenstein DA, Hammer SM, Hughes MD, et al. and AIDS Clinical Trials Group Study 175 Virology Study Team. The relation of virologic and immunologie markers to clinical outcomes after nucleoside therapy in HIV-infected adults with 200 to 500 CD4 cells per cubic millimeter. N Engl J Med 1996; 335: 1091–1098.PubMedCrossRefGoogle Scholar
  50. 50.
    Marschner IC, Collier AC, Coombs RW, et al. Use of changes in plasma levels of human immunodeficiency virus type 1 RNA to assess the clinical benefit of antiretroviral therapy. J Infect Dis. 1998; 177: 40–47.PubMedCrossRefGoogle Scholar
  51. 51.
    Perelson AS, Neumann AU, Markowitz M, et al. HIV-1 dynamics in vivo: virion clearance rate, infected cell lifetime, and viral generation time. Science. 1996; 271: 1582–1586.PubMedCrossRefGoogle Scholar
  52. 52.
    Perelson AS, Essunger P, Cao Y, et al. Decay characteristics of HIV-1-infected compartments during combination therapy. Nature. 1997; 387: 188–191.PubMedCrossRefGoogle Scholar
  53. 53.
    Haase AT, Henry K, Zupancic M, et al. Quantitative image analysis of HIV-1 infection in lymphoid tissue. Science. 1996; 274: 985–989.PubMedCrossRefGoogle Scholar
  54. 54.
    Cavert W, Notermans DW, Staskus K, et al. Kinetics of response in lymphoid tissues to antiretroviral therapy of HIV-1 infection. Science. 1997; 276: 960–964.PubMedCrossRefGoogle Scholar
  55. 55.
    Kempf D, Rode R, Xu Y, et al. The durability of response to protease inhibitor therapy is predicted by viral load, International Workshop on HIV Drug Resistance, Treatment Strategies and Eradication St. Petersburg, FL: June 25-28 1997 (Abstract).Google Scholar
  56. 56.
    Wong JK, Gunthard H, Havlir DV, et al. Reduction of HIV-1 in blood and lymph nodes following potent anti-retroviral therapy and the virologie correlates of treatment failure, Proc Natl Acad Sci USA 1997; 94: 12574–12579.PubMedCrossRefGoogle Scholar
  57. 57.
    Günthard HF, Wong JK, Ignacio CC, et al. HIV replication and genotypic resistance in blood and lymph nodes after one year of potent antiretroviral therapy. J Virol 1998; 72: 2422–2428.PubMedGoogle Scholar
  58. 58.
    Finzi D, Hermankova M, Pierson T, et al. Identification of a reservoir for HIV-1 in patients on highly active antiretroviral therapy. Science. 1997; 278: 1295–1300.PubMedCrossRefGoogle Scholar
  59. 59.
    Wong JK, Hezareh M, Gü nthard H, et al. Recovery of replication-competent HIV despite prolonged suppression of plasma viremia. Science. 1997; 278: 1291–1294.PubMedCrossRefGoogle Scholar
  60. 60.
    Saag MS, Holodniy M, Kuritzkes DR, et al. HIV viral load markers in clinical practice. Nature Medicine 1996; 2: 625–629.PubMedCrossRefGoogle Scholar
  61. 61.
    Carpenter CCJ, Fischl MA, Hammer SM, et al. Antiretroviral therapy for HIV infection in 1997: updated recommendations of the International AIDS Society-USA panel. JAMA 1997; 277: 1962–1968.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Douglas Richman
    • 1
  • Suzanne Crowe
    • 2
  • Katya Harvey
    • 2
  1. 1.Departments of Pathology and MedicineSan Diego Veterans Affairs Medical Center and University of California, San DiegoLa JollaUSA
  2. 2.Macfarlane Burnet Centre for Medical ResearchFairfieldAustralia

Personalised recommendations