Optimizing early infant diagnosis at delivery rooms with HIV-1 Abbott RealTime-PCR using phosphate buffered saline to complement low plasma volumes

•Early infant diagnosis is critical to improve the care of newborns living with HIV-1.•Neonate samples are difficult to collect and not uncommonly have small volumes.•Automated RNA quantification systems require minimal plasma volume.•Available plasma can be adjusted with phosphate buffered saline.•...

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Bibliographic Details
Published in:	Journal of clinical virology plus Vol. 2; no. 4; p. 100113
Main Authors:	Santos, Jaqueline Helena da Silva, Sichi, Andressa Coelho, Ahagon, Cintia Mayumi, Campos, Norberto Camilo, Brígido, Luís Fernando de Macedo
Format:	Journal Article
Language:	English
Published:	Elsevier Ltd 01-11-2022 Elsevier
Subjects:	Early infant diagnosis Neonatal Phosphate buffered saline Real-time PCR Viral load, HIV-1 Neonatal Early infant diagnosis Real-time PCR Phosphate buffered saline Viral load, HIV-1
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Summary:	•Early infant diagnosis is critical to improve the care of newborns living with HIV-1.•Neonate samples are difficult to collect and not uncommonly have small volumes.•Automated RNA quantification systems require minimal plasma volume.•Available plasma can be adjusted with phosphate buffered saline.•Dilution does not change the specificity of the test and allows HIV-1 diagnosis. Improving the early identification of HIV-1-infected newborns with birth testing is critical to comprehensive early infant diagnosis and care for newborns living with HIV-1. Automated RNA quantification systems are valuable diagnostic tools, but the volume of plasma that viral load platforms require makes their widespread use for young children difficult. Seventy-nine plasma samples with different viral load ranges were evaluated in parallel with the use of 1x PBS, pH 7.4, to supplement the required volume at dilutions factors from 1:2 to 1:50. Viral load quantification assays were evaluated using ABBOTT Molecular platforms, USA. Using 1x PBS, at 1:10 dilution (70 µL plasma in 630 µL 1x PBS), a sensitivity of 100% and 100% specificity were obtained for detecting a viremia above 400 copies/mL (Kappa of 0.96, p < 0, 0001) for 1:50 dilution the sensitivity was 96% and the specificity 100% (kappa 0.90, p < 0.0001). Although with reduced sensitivity, proportional to the dilution factor, the use of plasma does not influence the specificity of the test and allows the diagnosis of HIV-1 infections. Cases with very low viremia, a situation that may occur due to the treatment or prophylaxis of the mother and/or child, may go unnoticed with this procedure, and undiluted testing may be necessary.
ISSN:	2667-0380 2667-0380
DOI:	10.1016/j.jcvp.2022.100113