Performance of point-of-care xpert HIV-1 plasma viral load assay at a tertiary HIV care centre in Southern India

Background. Sustainable suppression of HIV replication forms the basis of anti-retroviral therapy (ART) medication. Thus, reliable quantification of HIV viral load has become an essential factor to monitor the effectiveness of the ART. Longer turnaround-time (TAT), batch testing and technical skills are major drawbacks of standard real-time PCR assays. Methods. The performance of the point-of-care Xpert HIV-1 viral load assay was evaluated against the Abbott RealTime PCR m2000rt system. A total of 96 plasma specimens ranging from 2.5 log10 copies ml^-1 to 4.99 log₁₀ copies ml^-1 and proficiency testing panel specimens were used. Precision and accuracy were checked using the Pearson correlation coefficient test and Bland-Altman analysis. Results. Compared to the Abbott RealTime PCR, the Xpert HIV-1 viral load assay showed a good correlation (Pearson r=0.81; P<0.0001) with a mean difference of 0.27 log10 copies ml^-1 (95%CI, -0.41 to 0.96 log₁₀ copies ml^-1; SD, 0.35 log10 copies ml^-1). Conclusion. Reliable and ease of testing individual specimens could make the Xpert HIV-1 viral load assay an efficient alternative method for ART monitoring in clinical management of HIV disease in resource-limited settings. The rapid test results (less than 2 h) could help in making an immediate clinical decision, which further strengthens patient care.