Performance of the Xpert HIV-1 Viral Load Assay: a Systematic Review and Meta-analysis

Nash, Madlen and Huddart, Sophie and Badar, Sayema and Baliga, Shrikala and Saravu, Kavitha and Pai, Madhukar (2018) Performance of the Xpert HIV-1 Viral Load Assay: a Systematic Review and Meta-analysis. Journal of Clinical Microbiology, 56 (4). pp. 1-8. ISSN 00951137

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Viral load (VL) is the preferred treatment-monitoring approach for HIVpositive patients. However, more rapid, near-patient, and low-complexity assays are needed to scale up VL testing. The Xpert HIV-1 VL assay (Cepheid, Sunnyvale, CA) is a new, automated molecular test, and it can leverage the GeneXpert systems that are being used widely for tuberculosis diagnosis. We systematically reviewed the evidence on the performance of this new tool in comparison to established reference standards. A total of 12 articles (13 studies) in which HIV patient VLs were compared between Xpert HIV VL assay and a reference standard VL assay were identified. Study quality was generally high, but substantial variability was observed in the number and type of agreement measures reported. Correlation coefficients between Xpert and reference assays were high, with a pooled Pearson correlation (n � 8) of 0.94 (95% confidence interval [CI], 0.89, 0.97) and Spearman correlation (n � 3) of 0.96 (95% CI, 0.86, 0.99). Bland-Altman metrics (n � 11) all were within 0.35 log copies/ ml of perfect agreement. Overall, Xpert HIV-1 VL performed well compared to current reference tests. The minimal training and infrastructure requirements for the Xpert HIV-1 VL assay make it attractive for use in resource-constrained settings, where point-of-care VL testing is most needed.

Item Type: Article
Uncontrolled Keywords: HIV, Xpert HIV-1, accuracy, diagnosis, viral load
Subjects: Medicine > KMC Mangalore > Microbiology
Medicine > KMC Manipal > Medicine
Depositing User: KMCMLR User
Date Deposited: 25 Sep 2018 09:53
Last Modified: 25 Sep 2018 09:53

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