Systematic review of the accuracy of plasma preparation tubes for HIV viral load testing.

Expanding access to HIV viral load testing is essential to improving the care and treatment of people living with HIV/AIDS and ending the AIDS epidemic. Though significant investments have been made in the past five years, many high burden, low resource countries continue to have viral load access r...

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Main Authors: Robert Luo, Jessica Markby, Jilian Sacks, Lara Vojnov
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0225393
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author Robert Luo
Jessica Markby
Jilian Sacks
Lara Vojnov
author_facet Robert Luo
Jessica Markby
Jilian Sacks
Lara Vojnov
author_sort Robert Luo
collection DOAJ
description Expanding access to HIV viral load testing is essential to improving the care and treatment of people living with HIV/AIDS and ending the AIDS epidemic. Though significant investments have been made in the past five years, many high burden, low resource countries continue to have viral load access rates below 50%. Plasma preparation tubes (PPTs) can simplify storage, transport, and preparation of plasma used for viral load testing. A systematic review was conducted to evaluate the accuracy of plasma preparation tubes for HIV viral load testing. Study results regarding the accuracy of PPT viral load measurements across various storage and transportation conditions were examined. The quality of evidence was evaluated using GRADE and QUADAS-2 criteria. The review identified 16 studies using PPTs with data from 6,141 individuals from 1995 to 2014. Overall the quality of evidence was rated as moderate, with unclear applicability for studies evaluating viral load assays that are no longer commercially available. Significantly elevated viral load results (>0.3 log copies/ml difference) have been observed with PPTs; however, when manufacturer handling instructions are followed, when plasma is aliquoted into a secondary tube, or when PPTs are centrifuged prior to testing, PPT results only differed from standard EDTA plasma testing using commercially available viral load assays by a range on average of -0.03 to +0.08 log copies/ml across studies. Although spuriously elevated viral load results have been observed with PPTs, following proper sample handing techniques have been shown to provide accurate results. PPTs, therefore, provide a high quality alternative specimen type for countries seeking solutions to infrastructure and specimen transportation challenges in an effort to scale-up viral load testing and achieve 90-90-90 targets.
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spelling doaj.art-c1bba42381a846d481068b5d45c3ba8c2022-12-21T18:36:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011411e022539310.1371/journal.pone.0225393Systematic review of the accuracy of plasma preparation tubes for HIV viral load testing.Robert LuoJessica MarkbyJilian SacksLara VojnovExpanding access to HIV viral load testing is essential to improving the care and treatment of people living with HIV/AIDS and ending the AIDS epidemic. Though significant investments have been made in the past five years, many high burden, low resource countries continue to have viral load access rates below 50%. Plasma preparation tubes (PPTs) can simplify storage, transport, and preparation of plasma used for viral load testing. A systematic review was conducted to evaluate the accuracy of plasma preparation tubes for HIV viral load testing. Study results regarding the accuracy of PPT viral load measurements across various storage and transportation conditions were examined. The quality of evidence was evaluated using GRADE and QUADAS-2 criteria. The review identified 16 studies using PPTs with data from 6,141 individuals from 1995 to 2014. Overall the quality of evidence was rated as moderate, with unclear applicability for studies evaluating viral load assays that are no longer commercially available. Significantly elevated viral load results (>0.3 log copies/ml difference) have been observed with PPTs; however, when manufacturer handling instructions are followed, when plasma is aliquoted into a secondary tube, or when PPTs are centrifuged prior to testing, PPT results only differed from standard EDTA plasma testing using commercially available viral load assays by a range on average of -0.03 to +0.08 log copies/ml across studies. Although spuriously elevated viral load results have been observed with PPTs, following proper sample handing techniques have been shown to provide accurate results. PPTs, therefore, provide a high quality alternative specimen type for countries seeking solutions to infrastructure and specimen transportation challenges in an effort to scale-up viral load testing and achieve 90-90-90 targets.https://doi.org/10.1371/journal.pone.0225393
spellingShingle Robert Luo
Jessica Markby
Jilian Sacks
Lara Vojnov
Systematic review of the accuracy of plasma preparation tubes for HIV viral load testing.
PLoS ONE
title Systematic review of the accuracy of plasma preparation tubes for HIV viral load testing.
title_full Systematic review of the accuracy of plasma preparation tubes for HIV viral load testing.
title_fullStr Systematic review of the accuracy of plasma preparation tubes for HIV viral load testing.
title_full_unstemmed Systematic review of the accuracy of plasma preparation tubes for HIV viral load testing.
title_short Systematic review of the accuracy of plasma preparation tubes for HIV viral load testing.
title_sort systematic review of the accuracy of plasma preparation tubes for hiv viral load testing
url https://doi.org/10.1371/journal.pone.0225393
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