Cargando…
Performance of the Xpert HIV-1 Viral Load Assay: a Systematic Review and Meta-analysis
Viral load (VL) is the preferred treatment-monitoring approach for HIV-positive patients. However, more rapid, near-patient, and low-complexity assays are needed to scale up VL testing. The Xpert HIV-1 VL assay (Cepheid, Sunnyvale, CA) is a new, automated molecular test, and it can leverage the Gene...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Society for Microbiology
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869835/ https://www.ncbi.nlm.nih.gov/pubmed/29386266 http://dx.doi.org/10.1128/JCM.01673-17 |
_version_ | 1783309351612579840 |
---|---|
author | Nash, Madlen Huddart, Sophie Badar, Sayema Baliga, Shrikala Saravu, Kavitha Pai, Madhukar |
author_facet | Nash, Madlen Huddart, Sophie Badar, Sayema Baliga, Shrikala Saravu, Kavitha Pai, Madhukar |
author_sort | Nash, Madlen |
collection | PubMed |
description | Viral load (VL) is the preferred treatment-monitoring approach for HIV-positive patients. However, more rapid, near-patient, and low-complexity assays are needed to scale up VL testing. The Xpert HIV-1 VL assay (Cepheid, Sunnyvale, CA) is a new, automated molecular test, and it can leverage the GeneXpert systems that are being used widely for tuberculosis diagnosis. We systematically reviewed the evidence on the performance of this new tool in comparison to established reference standards. A total of 12 articles (13 studies) in which HIV patient VLs were compared between Xpert HIV VL assay and a reference standard VL assay were identified. Study quality was generally high, but substantial variability was observed in the number and type of agreement measures reported. Correlation coefficients between Xpert and reference assays were high, with a pooled Pearson correlation (n = 8) of 0.94 (95% confidence interval [CI], 0.89, 0.97) and Spearman correlation (n = 3) of 0.96 (95% CI, 0.86, 0.99). Bland-Altman metrics (n = 11) all were within 0.35 log copies/ml of perfect agreement. Overall, Xpert HIV-1 VL performed well compared to current reference tests. The minimal training and infrastructure requirements for the Xpert HIV-1 VL assay make it attractive for use in resource-constrained settings, where point-of-care VL testing is most needed. |
format | Online Article Text |
id | pubmed-5869835 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | American Society for Microbiology |
record_format | MEDLINE/PubMed |
spelling | pubmed-58698352018-04-06 Performance of the Xpert HIV-1 Viral Load Assay: a Systematic Review and Meta-analysis Nash, Madlen Huddart, Sophie Badar, Sayema Baliga, Shrikala Saravu, Kavitha Pai, Madhukar J Clin Microbiol Virology Viral load (VL) is the preferred treatment-monitoring approach for HIV-positive patients. However, more rapid, near-patient, and low-complexity assays are needed to scale up VL testing. The Xpert HIV-1 VL assay (Cepheid, Sunnyvale, CA) is a new, automated molecular test, and it can leverage the GeneXpert systems that are being used widely for tuberculosis diagnosis. We systematically reviewed the evidence on the performance of this new tool in comparison to established reference standards. A total of 12 articles (13 studies) in which HIV patient VLs were compared between Xpert HIV VL assay and a reference standard VL assay were identified. Study quality was generally high, but substantial variability was observed in the number and type of agreement measures reported. Correlation coefficients between Xpert and reference assays were high, with a pooled Pearson correlation (n = 8) of 0.94 (95% confidence interval [CI], 0.89, 0.97) and Spearman correlation (n = 3) of 0.96 (95% CI, 0.86, 0.99). Bland-Altman metrics (n = 11) all were within 0.35 log copies/ml of perfect agreement. Overall, Xpert HIV-1 VL performed well compared to current reference tests. The minimal training and infrastructure requirements for the Xpert HIV-1 VL assay make it attractive for use in resource-constrained settings, where point-of-care VL testing is most needed. American Society for Microbiology 2018-03-26 /pmc/articles/PMC5869835/ /pubmed/29386266 http://dx.doi.org/10.1128/JCM.01673-17 Text en Copyright © 2018 Nash et al. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Virology Nash, Madlen Huddart, Sophie Badar, Sayema Baliga, Shrikala Saravu, Kavitha Pai, Madhukar Performance of the Xpert HIV-1 Viral Load Assay: a Systematic Review and Meta-analysis |
title | Performance of the Xpert HIV-1 Viral Load Assay: a Systematic Review and Meta-analysis |
title_full | Performance of the Xpert HIV-1 Viral Load Assay: a Systematic Review and Meta-analysis |
title_fullStr | Performance of the Xpert HIV-1 Viral Load Assay: a Systematic Review and Meta-analysis |
title_full_unstemmed | Performance of the Xpert HIV-1 Viral Load Assay: a Systematic Review and Meta-analysis |
title_short | Performance of the Xpert HIV-1 Viral Load Assay: a Systematic Review and Meta-analysis |
title_sort | performance of the xpert hiv-1 viral load assay: a systematic review and meta-analysis |
topic | Virology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869835/ https://www.ncbi.nlm.nih.gov/pubmed/29386266 http://dx.doi.org/10.1128/JCM.01673-17 |
work_keys_str_mv | AT nashmadlen performanceofthexperthiv1viralloadassayasystematicreviewandmetaanalysis AT huddartsophie performanceofthexperthiv1viralloadassayasystematicreviewandmetaanalysis AT badarsayema performanceofthexperthiv1viralloadassayasystematicreviewandmetaanalysis AT baligashrikala performanceofthexperthiv1viralloadassayasystematicreviewandmetaanalysis AT saravukavitha performanceofthexperthiv1viralloadassayasystematicreviewandmetaanalysis AT paimadhukar performanceofthexperthiv1viralloadassayasystematicreviewandmetaanalysis |