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Re: Lab using a new assay (and clade question)
Apr 13, 2008

This is regarding the question you answered on March 16, 2008. I checked with the lab: the switch was made from the Roche COBAS Amplicor to the Roche COBAS Ampliprep/Taqman (real-time PCR).

I had a follow-up question about clades. I'm 99% certain that I was infected in the U.S. (the Midwest to be a bit more specific), so I would have the group M, clade B virus. (The new test is supposed to detect HIV-1 values across clades A-H, group M.) But what if this weren't the case? I.e., what if I had been infected elsewhere, with a non-B clade virus? A sentence from a Canadian laboratory source: "However, for patients who have an endemic source for the HIV infection, i.e. higher likelihood of non-B clade, it is still a good idea to submit a baseline sample for clade and b-DNA testing." Do you agree?

The Midwestern university hospital where my bloodwork is done doesn't have/offer branched-DNA viral load testing. (Is that odd or normal?) My VL is 50 to 70 cpm, so very low (without meds). Two questions: I'd like to make sure I'm clade B -- what specific test should I request from the HIV nurse I see every quarter? And: would a research center like Aaron Diamond in New York (say) perform a b-DNA test for me with simply a self-referral?

Thank you, once again, for your time and expertise.

Response from Dr. Holodniy

There should be no problem with the real time PCR assay in detecting various clades. Since there is essentially no virus in your plasma to detect what clade you have, it would likely require cellular DNA from blood cells. I can't speak to whether this lab would perform such a test.



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