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Pooled nucleic acid testing to identify antiretroviral treatment failure during HIV infection in Seoul, South Korea

Authors
 Sun Bean Kim  ;  Hye Won Kim  ;  Hyon-Suk Kim  ;  Hea Won Ann  ;  Jae Kyoung Kim  ;  Heun Choi  ;  Min Hyung Kim  ;  Je Eun Song  ;  Jin Young Ahn  ;  Nam Su Ku  ;  Dong Hyun Oh  ;  Yong Chan Kim  ;  Su Jin Jeong  ;  Sang Hoon Han  ;  June Myung Kim  ;  Davey M. Smith  ;  Jun Yong Choi 
Citation
 SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES, Vol.46(2) : 136-140, 2014 
Journal Title
SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES
ISSN
 0036-5548 
Issue Date
2014
MeSH
Adult ; Aged ; Aged, 80 and over ; Anti-Retroviral Agents/therapeutic use* ; Drug Monitoring/economics ; Drug Monitoring/methods* ; Female ; HIV/genetics ; HIV/isolation & purification* ; HIV Infections/drug therapy* ; HIV Infections/virology ; Health Care Costs ; Humans ; Male ; Middle Aged ; Nucleic Acids/genetics ; Nucleic Acids/isolation & purification* ; Republic of Korea ; Specimen Handling/economics ; Specimen Handling/methods* ; Treatment Failure ; Viral Load/economics ; Viral Load/methods* ; Young Adult
Keywords
HIV ; pooling ; antiretroviral therapy ; viral load ; virologic failure
Abstract
Background: There have been various efforts to identify less costly but still accurate methods for monitoring the response to HIV treatment. We evaluated a pooling method to determine if this could improve screening efficiency and reduce costs while maintaining accuracy in Seoul, South Korea. Methods: We conducted the first prospective study of pooled nucleic acid testing (NAT) using a 5 minipool + algorithm strategy versus individual viral load testing for patients receiving antiretroviral therapy (ART) between November 2011 and August 2012 at an urban hospital in Seoul, South Korea. The viral load assay used has a lower level of detection of 20 HIV RNA copies/ml, and the cost per assay is US$ 136. The 5 minipool +algorithm strategy was applied and 43 pooled samples were evaluated. The relative efficiency and accuracy of the pooled NAT were compared with those of individual testing. Results: Using the individual viral load assay, 15 of 215 (7%) plasma samples had more than 200 HIV RNA copies/ml. The pooled NAT using the 5 minipool + algorithm strategy was applied to 43 pooled samples; 111 tests were needed to test all samples when virologic failure was defined at HIV RNA ≥ 200 copies/ml. Therefore, 104 tests were saved over individual testing, with a relative efficiency of 0.48. When evaluating costs, a total of US$ 14,144 was saved for 215 individual samples during 10 months. The negative predictive value was 99.5% for all samples with HIV RNA ≥ 200 copies/ml. Conclusions: The pooled NAT with 5 minipool + algorithm strategy seems to be a very promising approach to effectively monitor patients receiving ART and to save resources.
Full Text
http://informahealthcare.com/doi/abs/10.3109/00365548.2013.851415
DOI
10.3109/00365548.2013.851415
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Min Hyung(김민형)
Kim, Sun Bean(김선빈)
Kim, Yong Chan(김용찬)
Kim, Jae Kyoung(김재경)
Kim, June Myung(김준명)
Kim, Hyon Suk(김현숙) ORCID logo https://orcid.org/0000-0001-5662-7740
Kim, Hye Won(김혜원)
Song, Je Eun(송제은)
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
Ann, Hea Won(안혜원)
Oh, Dong Hyun(오동현)
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Choi, Heun(최흔) ORCID logo https://orcid.org/0000-0002-9622-9381
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98306
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