BACKGROUND: The optimum collection procedure for the evaluation of HIV-1 burden in ulcer secretions has not been well defined. OBJECTIVES: The objective of this study was to compare ulcer swabs and ulcer lavages for the detection and quantitation of HIV-1 RNA in genital ulcers. STUDY DESIGN:A convenience sample of the first 84 HIV-positive participants in a randomized double blind placebo controlled trial of acyclovir episodic treatment among men with genital ulcer disease were included in this evaluation. At baseline, participants were screened for HIV, syphilis and HSV-2 by serology and for ulcer etiology by PCR. Ulcer specimens were collected by using (1) a non-traumatic washing procedure with 10ml of PBS, and (2) sterile dry swabs. Ulcer samples were tested with HIV-1 Amplicor 1.5 Ultra Sensitive Assay with a lower threshold of 50 copies/ml. RESULTS: Of ulcer samples 35 (41.7%) had HIV detected by ulcer lavage and 32 (38.1%) by swabs (p=0.68). Overall, 45 (53.6%) were positive by one or both methods. The overall proportion of agreement was 73% (61/84). The chance-corrected proportion of agreement was 0.46 (95% CI: 0.26, 0.65) as estimated by the Kappa statistic. The log mean viral load from lavages (1.49log(10) copies/ml, 95% CI: 1.17-1.81) did not differ significantly from that of swabs (1.41log(10) copies/ml, 95% CI: 1.16-1.71) (p=0.29) with a mean difference of 0.08log copies/ml (SD 0.96). CONCLUSION: Ulcer lavage and ulcer swab performed in moderate agreement in the detection and quantitation of HIV RNA from ulcer specimens.
RCT Entities:
BACKGROUND: The optimum collection procedure for the evaluation of HIV-1 burden in ulcer secretions has not been well defined. OBJECTIVES: The objective of this study was to compare ulcer swabs and ulcer lavages for the detection and quantitation of HIV-1 RNA in genital ulcers. STUDY DESIGN: A convenience sample of the first 84 HIV-positive participants in a randomized double blind placebo controlled trial of acyclovirepisodic treatment among men with genital ulcer disease were included in this evaluation. At baseline, participants were screened for HIV, syphilis and HSV-2 by serology and for ulcer etiology by PCR. Ulcer specimens were collected by using (1) a non-traumatic washing procedure with 10ml of PBS, and (2) sterile dry swabs. Ulcer samples were tested with HIV-1 Amplicor 1.5 Ultra Sensitive Assay with a lower threshold of 50 copies/ml. RESULTS: Of ulcer samples 35 (41.7%) had HIV detected by ulcer lavage and 32 (38.1%) by swabs (p=0.68). Overall, 45 (53.6%) were positive by one or both methods. The overall proportion of agreement was 73% (61/84). The chance-corrected proportion of agreement was 0.46 (95% CI: 0.26, 0.65) as estimated by the Kappa statistic. The log mean viral load from lavages (1.49log(10) copies/ml, 95% CI: 1.17-1.81) did not differ significantly from that of swabs (1.41log(10) copies/ml, 95% CI: 1.16-1.71) (p=0.29) with a mean difference of 0.08log copies/ml (SD 0.96). CONCLUSION:Ulcer lavage and ulcer swab performed in moderate agreement in the detection and quantitation of HIV RNA from ulcer specimens.
Authors: Marta Bull; Caroline Mitchell; Jaime Soria; Sheila Styrchak; Corey Williams; Joan Dragavon; Kevin J Ryan; Edward Acosta; Frankline Onchiri; Robert W Coombs; Alberto La Rosa; Eduardo Ticona; Lisa M Frenkel Journal: J Infect Dis Date: 2020-08-04 Impact factor: 5.226
Authors: Janet M McNicholl; Wanna Leelawiwat; Sara Whitehead; Debra L Hanson; Tammy Evans-Strickfaden; Chen Y Cheng; Wannee Chonwattana; Famui Mueanpai; Chonticha Kittinunvorakoon; Lauri Markowitz; Eileen F Dunne Journal: Int J STD AIDS Date: 2016-07-10 Impact factor: 1.359
Authors: Aaron A R Tobian; Godfrey Kigozi; Jordyn Manucci; Mary K Grabowski; David Serwadda; Richard Musoke; Andrew D Redd; Fred Nalugoda; Steven J Reynolds; Nehemiah Kighoma; Oliver Laeyendecker; Justin Lessler; Ronald H Gray; Thomas C Quinn; Maria J Wawer Journal: PLoS Med Date: 2015-04-28 Impact factor: 11.069