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Higher HIV-1 RNA cutoff level required in cerebrospinal fluid than in blood to predict positive HIV-1 isolation

Artikel i vetenskaplig tidskrift
Författare Lars-Magnus Andersson
Bo Svennerholm
Lars Hagberg
Magnus Gisslén
Publicerad i J Med Virol
Volym 62
Nummer/häfte 1
Sidor 9-13
Publiceringsår 2000
Publicerad vid Institutionen för invärtesmedicin, Avdelningen för infektionssjukdomar
Institutionen för laboratoriemedicin, Avdelningen för klinisk virologi
Sidor 9-13
Språk en
Länkar www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Acquired Immunodeficiency Syndrome/diagnosis/immunology/*virology, Adolescent, Adult, Aged, CD4 Lymphocyte Count, Female, *HIV Seropositivity/blood/cerebrospinal fluid, HIV-1/*isolation & purification, Humans, Male, Mass Screening, Middle Aged, Predictive Value of Tests, *RNA, Viral/blood/cerebrospinal fluid, Sensitivity and Specificity
Ämneskategorier Mikrobiologi inom det medicinska området

Sammanfattning

HIV-1 can be isolated from the vast majority of blood samples taken from HIV-1-seropositive patients not treated with antiretroviral drugs. Isolation rates from cerebrospinal fluid (CSF) samples are considerably lower, ranging between 20-70%. The objective of this study was to determine the cutoff levels for HIV-1 RNA that would yield a positive predictive value > or =90% for positive virus isolation from CSF and blood. Quantitative HIV-1 RNA PCR (Amplicor HIV monitor, version 1.0, Roche Diagnostic Systems) and virus isolation were used to examine 303 CSF samples and 278 paired blood samples from 157 HIV-1-seropositive patients. Patients on antiretroviral treatment provided 140 of the CSF samples and 131 of the blood samples. CSF samples that were positive by culture numbered 137 of 303 (45%), as compared with 216 of 278 (78%) blood samples. In the case of samples taken from patients with antiretroviral treatment, 28% were positive by culture from CSF and 63% from blood. As expected, mean HIV-1 RNA levels were higher in CSF and blood samples positive by culture than in samples negative by culture. A cutoff level of >5,000 HIV-1 RNA copies/ml was required to yield a positive predictive value for positive virus isolation from CSF samples of > or =90%, whereas the cutoff level for blood samples was just above the detection limit of the assay (>200 HIV-1 copies/ml).

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