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

Sun Bean Kim, Hye Won Kim, Hyonsuk 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, JunYong Choi

Research output: Contribution to journalArticle

6 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)136-140
Number of pages5
JournalScandinavian Journal of Infectious Diseases
Volume46
Issue number2
DOIs
Publication statusPublished - 2014 Feb 1

Fingerprint

Republic of Korea
Treatment Failure
Nucleic Acids
HIV Infections
HIV
Viral Load
RNA
Costs and Cost Analysis
Urban Hospitals
Therapeutics
Seoul
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Kim, Sun Bean ; Kim, Hye Won ; Kim, Hyonsuk ; Ann, Hea Won ; Kim, Jae Kyoung ; Choi, Heun ; Kim, Min Hyung ; Song, Je Eun ; Ahn, Jin Young ; Ku, Nam Su ; Oh, Dong Hyun ; Kim, Yong Chan ; Jeong, Su Jin ; Han, Sang Hoon ; Kim, June Myung ; Smith, Davey M. ; Choi, JunYong. / Pooled nucleic acid testing to identify antiretroviral treatment failure during HIV infection in Seoul, South Korea. In: Scandinavian Journal of Infectious Diseases. 2014 ; Vol. 46, No. 2. pp. 136-140.
@article{35a74dca34fd47468720dfe1a02801aa,
title = "Pooled nucleic acid testing to identify antiretroviral treatment failure during HIV infection in Seoul, South Korea",
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.",
author = "Kim, {Sun Bean} and Kim, {Hye Won} and Hyonsuk Kim and Ann, {Hea Won} and Kim, {Jae Kyoung} and Heun Choi and Kim, {Min Hyung} and Song, {Je Eun} and Ahn, {Jin Young} and Ku, {Nam Su} and Oh, {Dong Hyun} and Kim, {Yong Chan} and Jeong, {Su Jin} and Han, {Sang Hoon} and Kim, {June Myung} and Smith, {Davey M.} and JunYong Choi",
year = "2014",
month = "2",
day = "1",
doi = "10.3109/00365548.2013.851415",
language = "English",
volume = "46",
pages = "136--140",
journal = "Infectious Diseases",
issn = "2374-4235",
publisher = "Taylor and Francis Ltd.",
number = "2",

}

Kim, SB, Kim, HW, Kim, H, Ann, HW, Kim, JK, Choi, H, Kim, MH, Song, JE, Ahn, JY, Ku, NS, Oh, DH, Kim, YC, Jeong, SJ, Han, SH, Kim, JM, Smith, DM & Choi, J 2014, 'Pooled nucleic acid testing to identify antiretroviral treatment failure during HIV infection in Seoul, South Korea', Scandinavian Journal of Infectious Diseases, vol. 46, no. 2, pp. 136-140. https://doi.org/10.3109/00365548.2013.851415

Pooled nucleic acid testing to identify antiretroviral treatment failure during HIV infection in Seoul, South Korea. / Kim, Sun Bean; Kim, Hye Won; Kim, Hyonsuk; Ann, Hea Won; Kim, Jae Kyoung; Choi, Heun; Kim, Min Hyung; Song, Je Eun; Ahn, Jin Young; Ku, Nam Su; Oh, Dong Hyun; Kim, Yong Chan; Jeong, Su Jin; Han, Sang Hoon; Kim, June Myung; Smith, Davey M.; Choi, JunYong.

In: Scandinavian Journal of Infectious Diseases, Vol. 46, No. 2, 01.02.2014, p. 136-140.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pooled nucleic acid testing to identify antiretroviral treatment failure during HIV infection in Seoul, South Korea

AU - Kim, Sun Bean

AU - Kim, Hye Won

AU - Kim, Hyonsuk

AU - Ann, Hea Won

AU - Kim, Jae Kyoung

AU - Choi, Heun

AU - Kim, Min Hyung

AU - Song, Je Eun

AU - Ahn, Jin Young

AU - Ku, Nam Su

AU - Oh, Dong Hyun

AU - Kim, Yong Chan

AU - Jeong, Su Jin

AU - Han, Sang Hoon

AU - Kim, June Myung

AU - Smith, Davey M.

AU - Choi, JunYong

PY - 2014/2/1

Y1 - 2014/2/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84892650620&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84892650620&partnerID=8YFLogxK

U2 - 10.3109/00365548.2013.851415

DO - 10.3109/00365548.2013.851415

M3 - Article

VL - 46

SP - 136

EP - 140

JO - Infectious Diseases

JF - Infectious Diseases

SN - 2374-4235

IS - 2

ER -