RSS Feeds
Polymerase Chain Reaction for Diagnosis of HIV Infection
- Arthur E. Brown, MD, MPH;
- Merlin Robb, MD; and
- Francine McCutchan, PhD
- Walter Reed Army Institute of Research, Washington, DC 20307 Henry M. Jackson Foundation, Rockville, MD 20850
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
The recent paper by Owens and colleagues [1] presents a meta-analysis of the performance of polymerase chain reaction (PCR) for the diagnosis of human immunodeficiency virus type 1 (HIV-1) infection. The authors do not comment on either the genetic sequences to which the PCR primers are targeted or the genetic differences documented among the subtypes of HIV-1. Variability in PCR across subtypes was the subject of a recent UNAIDS meeting, at which the need for further assay development was identified [2].
At the Walter Reed Army Institute of Research, a DNA PCR assay is used to supplement serologic testing for HIV diagnosis. The gag primer pairs used, both of which must be reactive for a positive result, are commercially available and widely used. We have investigated the assay's sensitivity for non-B-subtype viruses. Cell pellets from co-cultures of genetically typed viruses (n = 28) were selected to represent the major HIV-1 subtypes. In a blinded manner, DNA was extracted and serial dilutions were assayed by PCR. One pair of primers (SK462/SK431) amplified DNA from all specimens. The other pair (SK38/SK39) amplified only 3 of 5 preparations from subtype A, 4 of 5 from subtype B, 3 of 5 from subtype C, 2 of 5 from subtype D, 4 of 5 from subtype E, and 0 of 3 from subtype F.
Thus, although we agree with the recommendations about study design by Owens and colleagues [1], the level of PCR sensitivity derived from their analysis should not be assumed to be valid for non-subtype-B viruses. Using available nucleic acid sequences, it is now possible to select more “universal” primers for all known subtypes of HIV-1. Modification of amplification conditions may also improve sensitivity across multiple clades but, to our knowledge, no DNA PCR methods have been verified to amplify all subtypes equally. It would serve a useful surveillance function to have both “universal” and subtype-B-specific primers as part of a diagnostic PCR algorithm.
Arthur E. Brown, MD, MPH
Merlin Robb, MD
Walter Reed Army Institute of Research; Washington, DC 20307
Francine McCutchan, PhD
Henry M. Jackson Foundation; Rockville, MD 20850
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
