Performance evaluation of a laboratory developed PCR test for quantitation of HIV-2 viral RNA

PLoS One. 2020 Feb 28;15(2):e0229424. doi: 10.1371/journal.pone.0229424. eCollection 2020.

Abstract

Management of Human Immunodeficiency Virus Type 2 (HIV-2) infections present unique challenges due to low viral titers, slow disease progression, and poor response to standard antiviral therapies. The need for a nucleic acid assay to detect and quantify HIV-2 virus has led to the development of a number of molecular-based assays for detection and/or quantification of HIV-2 viral RNA in plasma in order to provide laboratory evidence of HIV-2 infection and viral loads for use in treatment decisions. As HIV-2 is less pathogenic and transmissible than HIV-1 and has resistance to several of the antiretroviral drugs, delay of treatment is common. Cross sero-reactivity between HIV-1 and HIV-2 makes it difficult to distinguish between the two viruses based upon serological tests. As such we developed a quantitative reverse transcription PCR (qRT-PCR) assay targeting the 5' long terminal repeat of HIV-2 for detection and quantification of HIV-2 viral RNA in plasma to identify HIV-2 infection and for use in viral load monitoring. Serial dilutions of cultured HIV-2 virus demonstrated a wide dynamic range (10 to 100,000 copies/ml) with excellent reproducibility (standard deviation from 0.12-0.19), linearity (R2 = 0.9994), and a lower limit of detection at 79 copies/ml (NIH-Z). The assay is highly specific for HIV-2 Groups A and B and exhibits no cross reactivity to HIV-1, HBV or HCV. Precision of the assay was demonstrated for the High (Mean = 6.41; SD = 0.12) and Medium (Mean = 4.46; SD = 0.13) HIV-2 positive controls. Replicate testing of clinical specimens showed good reproducibility above 1,000 copies/ml, with higher variability under 1,000 copies/ml. Analysis of 220 plasma samples from HIV-2 infected West African individuals demonstrated significantly lower viral loads than those observed in HIV-1 infections, consistent with results of previous studies. Slightly more than seven percent of clinical samples (7.3%) demonstrated viral loads above 100,000 copies/ml, while 37.3% of samples were undetectable. The high sensitivity, specificity, precision, and linearity of the WRAIR qRT-PCR assay makes it well suited for detection and monitoring of HIV-2 RNA levels in plasma of infected individuals.

Publication types

  • Evaluation Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Case-Control Studies
  • HIV Infections / blood
  • HIV Infections / diagnosis*
  • HIV Infections / virology
  • HIV-1 / genetics*
  • HIV-1 / isolation & purification
  • HIV-2 / genetics*
  • HIV-2 / isolation & purification
  • Humans
  • Laboratories / standards*
  • RNA, Viral / blood
  • RNA, Viral / genetics*
  • Reagent Kits, Diagnostic
  • Real-Time Polymerase Chain Reaction / methods*
  • Serologic Tests / standards*
  • Viral Load

Substances

  • RNA, Viral
  • Reagent Kits, Diagnostic

Associated data

  • Dryad/10.5061/dryad.95x96p8fx

Grants and funding

This work was supported by the US Army Medical Research and Materiel Command, Cooperative Agreement W81-XWH-11-2-0174 to Henry M. Jackson Foundation (HJF): MMM, YL, HRH are HJF employees and Contract No. W81-XWH-18-C-0337 to Henry M. Jackson Foundation (HJF): MMM, YL and HRH are HJF employees. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.