The Development of a Standardized Quality Assessment Material to Support Xpert<sup>®</sup> HIV-1 Viral Load Testing for ART Monitoring in South Africa
The tiered laboratory framework for human immunodeficiency virus (HIV) viral load monitoring accommodates a range of HIV viral load testing platforms, with quality assessment critical to ensure quality patient testing. HIV plasma viral load testing is challenged by the instability of viral RNA. An a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/2/160 |
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| author | Lara Dominique Noble Lesley Erica Scott Asiashu Bongwe Pedro Da Silva Wendy Susan Stevens |
| author_facet | Lara Dominique Noble Lesley Erica Scott Asiashu Bongwe Pedro Da Silva Wendy Susan Stevens |
| author_sort | Lara Dominique Noble |
| collection | DOAJ |
| description | The tiered laboratory framework for human immunodeficiency virus (HIV) viral load monitoring accommodates a range of HIV viral load testing platforms, with quality assessment critical to ensure quality patient testing. HIV plasma viral load testing is challenged by the instability of viral RNA. An approach using an RNA stabilizing buffer is described for the Xpert<sup>®</sup> HIV-1 Viral Load (Cepheid) assay and was tested in remote laboratories in South Africa. Plasma panels with known HIV viral titres were prepared in PrimeStore molecular transport medium for per-module verification and per-instrument external quality assessment. The panels were transported at ambient temperatures to 13 testing laboratories during 2017 and 2018, tested according to standard procedures and uploaded to a web portal for analysis. A total of 275 quality assessment specimens (57 verification panels and two EQA cycles) were tested. All participating laboratories met study verification criteria (<i>n</i> = 171 specimens) with an overall concordance correlation coefficient (ρ<sub>c</sub>) of 0.997 (95% confidence interval (CI): 0.996 to 0.998) and a mean bias of −0.019 log copies per milliliter (cp/mL) (95% CI: −0.044 to 0.063). The overall EQA ρ<sub>c</sub> (<i>n</i> = 104 specimens) was 0.999 (95% CI: 0.998 to 0.999), with a mean bias of 0.03 log cp/mL (95% CI: 0.02 to 0.05). These panels are suitable for use in quality monitoring of Xpert<sup>®</sup> HIV-1 VL and are applicable to laboratories in remote settings. |
| first_indexed | 2024-03-09T03:59:48Z |
| format | Article |
| id | doaj.art-bfcf6c53eeec4b81bc71c00a91a3134d |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T03:59:48Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-bfcf6c53eeec4b81bc71c00a91a3134d2023-12-03T14:16:02ZengMDPI AGDiagnostics2075-44182021-01-0111216010.3390/diagnostics11020160The Development of a Standardized Quality Assessment Material to Support Xpert<sup>®</sup> HIV-1 Viral Load Testing for ART Monitoring in South AfricaLara Dominique Noble0Lesley Erica Scott1Asiashu Bongwe2Pedro Da Silva3Wendy Susan Stevens4Department of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, Gauteng, South AfricaDepartment of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, Gauteng, South AfricaNational Priority Program, National Health Laboratory Service, Johannesburg 2000, Gauteng, South AfricaNational Priority Program, National Health Laboratory Service, Johannesburg 2000, Gauteng, South AfricaDepartment of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, Gauteng, South AfricaThe tiered laboratory framework for human immunodeficiency virus (HIV) viral load monitoring accommodates a range of HIV viral load testing platforms, with quality assessment critical to ensure quality patient testing. HIV plasma viral load testing is challenged by the instability of viral RNA. An approach using an RNA stabilizing buffer is described for the Xpert<sup>®</sup> HIV-1 Viral Load (Cepheid) assay and was tested in remote laboratories in South Africa. Plasma panels with known HIV viral titres were prepared in PrimeStore molecular transport medium for per-module verification and per-instrument external quality assessment. The panels were transported at ambient temperatures to 13 testing laboratories during 2017 and 2018, tested according to standard procedures and uploaded to a web portal for analysis. A total of 275 quality assessment specimens (57 verification panels and two EQA cycles) were tested. All participating laboratories met study verification criteria (<i>n</i> = 171 specimens) with an overall concordance correlation coefficient (ρ<sub>c</sub>) of 0.997 (95% confidence interval (CI): 0.996 to 0.998) and a mean bias of −0.019 log copies per milliliter (cp/mL) (95% CI: −0.044 to 0.063). The overall EQA ρ<sub>c</sub> (<i>n</i> = 104 specimens) was 0.999 (95% CI: 0.998 to 0.999), with a mean bias of 0.03 log cp/mL (95% CI: 0.02 to 0.05). These panels are suitable for use in quality monitoring of Xpert<sup>®</sup> HIV-1 VL and are applicable to laboratories in remote settings.https://www.mdpi.com/2075-4418/11/2/160HIV viral loadexternal quality assessmentverificationqualitythermostablePrimeStore MTM0 |
| spellingShingle | Lara Dominique Noble Lesley Erica Scott Asiashu Bongwe Pedro Da Silva Wendy Susan Stevens The Development of a Standardized Quality Assessment Material to Support Xpert<sup>®</sup> HIV-1 Viral Load Testing for ART Monitoring in South Africa Diagnostics HIV viral load external quality assessment verification quality thermostable PrimeStore MTM0 |
| title | The Development of a Standardized Quality Assessment Material to Support Xpert<sup>®</sup> HIV-1 Viral Load Testing for ART Monitoring in South Africa |
| title_full | The Development of a Standardized Quality Assessment Material to Support Xpert<sup>®</sup> HIV-1 Viral Load Testing for ART Monitoring in South Africa |
| title_fullStr | The Development of a Standardized Quality Assessment Material to Support Xpert<sup>®</sup> HIV-1 Viral Load Testing for ART Monitoring in South Africa |
| title_full_unstemmed | The Development of a Standardized Quality Assessment Material to Support Xpert<sup>®</sup> HIV-1 Viral Load Testing for ART Monitoring in South Africa |
| title_short | The Development of a Standardized Quality Assessment Material to Support Xpert<sup>®</sup> HIV-1 Viral Load Testing for ART Monitoring in South Africa |
| title_sort | development of a standardized quality assessment material to support xpert sup r sup hiv 1 viral load testing for art monitoring in south africa |
| topic | HIV viral load external quality assessment verification quality thermostable PrimeStore MTM0 |
| url | https://www.mdpi.com/2075-4418/11/2/160 |
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