ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2011
Pooling strategies to reduce the cost of HIV-1 RNA load monitoring in a resource-limited setting.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Improved HIV-1 Viral Load Monitoring Capacity Using Pooled Testing With Marker-Assisted Deconvolution.Journal of acquired immune deficiency syndromes (1999) · 2017Pooled it
- Factors affecting detection and quantification of Schistosoma haematobium eggs in pooled urine samples.PLoS neglected tropical diseases · 2026Article
- Implementation of pooled testing to increase access to routine viral load monitoring for people living with HIV on antiretroviral therapy.Scientific reports · 2025Article
- Performance of Urine Reagent Test Strips in DetectingMicroorganisms · 2025Article
- Clinical sensitivity and time-to-result of a cascaded pooled testing approach for assessing the prevalence and intensity of Schistosoma haematobium infection.PLoS neglected tropical diseases · 2024Article
- A proactive/reactive mass screening approach with uncertain symptomatic cases.PLoS computational biology · 2024Article
- SARS-CoV-2 detection in multi-sample pools in a real pandemic scenario: A screening strategy of choice for active surveillance.PloS one · 2022Article
- Pooled Specimen Testing Using Automated Cartridge-Based System for COVID-19: The Cost on Sensitivity.The Malaysian journal of medical sciences : MJMS · 2021Article
- Application of dried blood spot sample pooling strategies for Plasmodium 18S rRNA biomarker testing to facilitate identification of infected persons in large-scale epidemiological studies.Malaria journal · 2021Article
- Prediction-driven pooled testing methods: Application to HIV treatment monitoring in Rakai, Uganda.Statistics in medicine · 2021Article
- Sample pooling for SARS-CoV-2 RT-PCR screening.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2020Article
- Pooled testing: A tool to increase efficiency of infant HIV diagnosis and virological monitoring.African journal of laboratory medicine · 2020Review
- When to use one-dimensional, two-dimensional, and Shifted Transversal Design pooling in mycotoxin screening.PloS one · 2020Article
- Rates of HIV-1 virological suppression and patterns of acquired drug resistance among fisherfolk on first-line antiretroviral therapy in Uganda.The Journal of antimicrobial chemotherapy · 2019Article
- Point-of-care viral load monitoring: outcomes from a decentralized HIV programme in Malawi.Journal of the International AIDS Society · 2019Article
- Pooled PCR testing of dried blood spots for infant HIV diagnosis is cost efficient and accurate.BMC infectious diseases · 2019Article
- Occult HBV infection in HIV-infected adults and evaluation of pooled NAT for HBV.Journal of viral hepatitis · 2018Article
- Clinical Benefits and Cost-Effectiveness of Laboratory Monitoring Strategies to Guide Antiretroviral Treatment Switching in India.AIDS research and human retroviruses · 2018Article
- Reevaluating Cumulative HIV-1 Viral Load as a Prognostic Predictor: Predicting Opportunistic Infection Incidence and Mortality in a Ugandan Cohort.American journal of epidemiology · 2016Article
- Predicting resistance as indicator for need to switch from first-line antiretroviral therapy among patients with elevated viral loads: development of a risk score algorithm.BMC infectious diseases · 2016Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundQuantitative human immunodeficiency virus (HIV) RNA load testing surpasses CD4 cell count and clinical monitoring in detecting antiretroviral therapy (ART) failure; however, its cost can be prohibitive. Recently, the use of pooling strategies with a clinically appropriate viral load threshold was shown to be accurate and efficient for monitoring when the prevalence of virologic failure is low.
methodsWe used laboratory request form information to identify specimens with a low pretest probability of virologic failure. Patients aged ≥15 years who were receiving first-line ART had individual viral load results available were eligible. Blood plasma, dried blood spots, and dried plasma spots were evaluated. Two pooling strategies were compared: minipools of 5 samples and a 10 ×10 matrix platform (liquid plasma specimens only). A deconvolution algorithm was used to identify specimens(s) with detectable viral loads.
resultsThe virologic failure rate in the study sample was <10%. Specimens included were liquid plasma specimens tested in minipools(n = 400), of which 300 were available for testing by matrix, and specimens tested with minipools only: dried blood spots (n = 100) and dried plasma spots (n = 185). Pooling methods resulted in 30.5%-60% fewer HIV RNA tests required to screen the study sample. For plasma pooling, the matrix strategy had the better efficiency, but minipools of 5 dried blood spots had the best efficiency overall and were accurate at a >95% negative predictive value with minimal technical requirements.
conclusionsIn resource-constrained settings, a combination of preselection of patients with low pretest probability of virologic failure and pooled testing can reduce the cost of virologic monitoring without compromising accuracy.
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