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Higher HIV‐1 RNA cutoff level required in cerebrospinal fluid than in blood to predict positive HIV‐1 isolation
Author(s) -
Andersson LarsMagnus,
Svennerholm Bo,
Hagberg Lars,
Gisslén Magnus
Publication year - 2000
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/1096-9071(200009)62:1<9::aid-jmv2>3.0.co;2-d
Subject(s) - cerebrospinal fluid , virology , virus , human immunodeficiency virus (hiv) , cutoff , viral disease , medicine , viral load , immunology , biology , physics , quantum mechanics
HIV‐1 can be isolated from the vast majority of blood samples taken from HIV‐1‐seropositive patients not treated with antiretroviral drugs. Isolation rates from cerebrospinal fluid (CSF) samples are considerably lower, ranging between 20–70%. The objective of this study was to determine the cutoff levels for HIV‐1 RNA that would yield a positive predictive value ≥90% for positive virus isolation from CSF and blood. Quantitative HIV‐1 RNA PCR (Amplicor HIV monitor, version 1.0, Roche Diagnostic Systems) and virus isolation were used to examine 303 CSF samples and 278 paired blood samples from 157 HIV‐1‐seropositive patients. Patients on antiretroviral treatment provided 140 of the CSF samples and 131 of the blood samples. CSF samples that were positive by culture numbered 137 of 303 (45%), as compared with 216 of 278 (78%) blood samples. In the case of samples taken from patients with antiretroviral treatment, 28% were positive by culture from CSF and 63% from blood. As expected, mean HIV‐1 RNA levels were higher in CSF and blood samples positive by culture than in samples negative by culture. A cutoff level of >5,000 HIV‐1 RNA copies/ml was required to yield a positive predictive value for positive virus isolation from CSF samples of ≥90%, whereas the cutoff level for blood samples was just above the detection limit of the assay (>200 HIV‐1 copies/ml). J. Med. Virol. 62:9–13, 2000. © 2000 Wiley‐Liss, Inc.