Pooled nucleic acid testing to detect antiretroviral treatment failure in Mexico

摘要: BACKGROUND Similar to other resource-limited settings, cost restricts availability of viral load monitoring for most patients receiving antiretroviral therapy in Tijuana, Mexico. We evaluated if a pooling method could improve efficiency and reduce costs while maintaining accuracy. METHODS 700 patient blood plasma specimens at reference laboratory Tijuana detectable viremia, individually 10 × matrix pools. Thresholds virologic failure were set ≥500, ≥1000 ≥1500 HIV RNA copies per milliliter. Detectable pools deconvoluted using pre-set algorithms. Accuracy the compared with individual testing. Quality assurance (QA) measures after 1 demonstrated low relative RESULTS Twenty-two percent cohort had (≥50 copies/mL). Pooling methods saved approximately one third assays over testing, negative predictive values >90% detect samples One would have been detected earlier developed QA measures, but its exclusion only increased from 39% 42%. These between $13,223 $14,308 this cohort. CONCLUSIONS Despite limited clinical data, high prevalence loads contaminated matrix, greatly improved By improving cost-effectiveness, these provide sustainability incorporation will likely maximize future uses.