Cost-effective HIV-1 virological monitoring in resource-limited settings using a modified commercially available qPCR RNA assay

Jayaseelan Boobalan, Andrea Torti, Thongadi Ramesh Dinesha, Sunil Suhas Solomon, Pachamuthu Balakrishnan, Shanmugam Saravanan

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Virological monitoring through plasma viral load (PVL) quantification is essential for clinical management of HIV patients undergoing antiretroviral treatment (ART), and for detecting treatment failure. Quantitative PCR (qPCR)-based tests are the gold standard for measuring PVL. Largely because of their high cost, however, implementation of these tests in low- and middle-income countries fails to cover the testing demand. In this study, we aimed at reducing the running cost of the commercially available Abbott RealTime™ HIV-1 assay by minimizing the reagent consumption. To this end, a modified version of the assay was obtained by reducing the assay's reagents volume to about a half, and validated using a panel of 104 plasma samples. Compared to the standard version, the modified Abbott assay allowed for a 50% reduction in running costs. At the same time, it showed a 100% concordance in identifying samples with detectable viral load, strong correlation (Pearson's r = 0.983, P < 0.0001), and a high agreement between PVL values (mean percent difference between PVL values ± standard deviation = 0.76 ± 3.18%). In detecting viral failure (PVL > 1000 copies mL−1), the modified assay showed a sensitivity of 94.6%, a specificity of 93.8%, and a negative and positive predictive values of 93.8% and 94.6%, respectively. The modified assay therefore reliably quantifies PVL, predicts viral failure, and allows for a ca. 50% reduction in the assay's running costs. It may thus be implemented as an ART monitoring tool in resource-limited settings and for research purposes.

Original languageEnglish (US)
Pages (from-to)71-76
Number of pages6
JournalJournal of Virological Methods
StatePublished - Oct 2017


  • ART monitoring
  • Abbott RealTime
  • Cost-effective assay
  • HIV-1

ASJC Scopus subject areas

  • Virology


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