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Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1996 Dec;34(12):3196–3202. doi: 10.1128/jcm.34.12.3196-3202.1996

An enhanced-sensitivity branched-DNA assay for quantification of human immunodeficiency virus type 1 RNA in plasma.

D Kern 1, M Collins 1, T Fultz 1, J Detmer 1, S Hamren 1, J J Peterkin 1, P Sheridan 1, M Urdea 1, R White 1, T Yeghiazarian 1, J Todd 1
PMCID: PMC229482  PMID: 8940471

Abstract

The quantification of human immunodeficiency virus type 1 (HIV-1) RNA has facilitated clinical research and expedited the development of antiretroviral drugs. The branched-DNA (bDNA) assay provides a reliable method for the quantification of HIV-1 RNA in human plasma and is considered one of the most reproducible assays ready for use in clinical trials. A series of oligonucleotide probe design and solution changes have been developed to enhance the sensitivity of the bDNA assay while maintaining its performance characteristics. Among the changes incorporated into the enhanced-sensitivity bDNA (ES bDNA) assay to reduce the background level and enhance the signal are the use of shorter overhang sequences of target probes for capture, the cruciform design of target probes for amplification, and the addition of preamplifier molecules. The ES bDNA assay is at least 20-fold more sensitive than the first-generation bDNA assay, yet it maintains a high level of accuracy, linearity, and reproducibility. Further, quantification values obtained with the ES bDNA assay and the first-generation bDNA assay are highly correlated, thus allowing for meaningful comparisons of HIV-1 RNA levels in specimens tested with either assay. The ES bDNA assay may be useful in determining the prognostic value of HIV-1 RNA levels of below 10,000 copies per ml and in assessing the clinical benefit of antiretroviral therapy-induced decreases in plasma HIV-1 RNA sustained at levels of below 10,000 copies per ml.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aoki-Sei S., Yarchoan R., Kageyama S., Hoekzema D. T., Pluda J. M., Wyvill K. M., Broder S., Mitsuya H. Plasma HIV-1 viremia in HIV-1 infected individuals assessed by polymerase chain reaction. AIDS Res Hum Retroviruses. 1992 Jul;8(7):1263–1270. doi: 10.1089/aid.1992.8.1263. [DOI] [PubMed] [Google Scholar]
  2. Biron F., Lucht F., Peyramond D., Fresard A., Vallet T., Nugier F., Grange J., Malley S., Hamedi-Sangsari F., Vila J. Anti-HIV activity of the combination of didanosine and hydroxyurea in HIV-1-infected individuals. J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Sep 1;10(1):36–40. [PubMed] [Google Scholar]
  3. Cao Y., Ho D. D., Todd J., Kokka R., Urdea M., Lifson J. D., Piatak M., Jr, Chen S., Hahn B. H., Saag M. S. Clinical evaluation of branched DNA signal amplification for quantifying HIV type 1 in human plasma. AIDS Res Hum Retroviruses. 1995 Mar;11(3):353–361. doi: 10.1089/aid.1995.11.353. [DOI] [PubMed] [Google Scholar]
  4. Collins M. L., Zayati C., Detmer J. J., Daly B., Kolberg J. A., Cha T. A., Irvine B. D., Tucker J., Urdea M. S. Preparation and characterization of RNA standards for use in quantitative branched DNA hybridization assays. Anal Biochem. 1995 Mar 20;226(1):120–129. doi: 10.1006/abio.1995.1199. [DOI] [PubMed] [Google Scholar]
  5. Connor R. I., Mohri H., Cao Y., Ho D. D. Increased viral burden and cytopathicity correlate temporally with CD4+ T-lymphocyte decline and clinical progression in human immunodeficiency virus type 1-infected individuals. J Virol. 1993 Apr;67(4):1772–1777. doi: 10.1128/jvi.67.4.1772-1777.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Danner S. A., Carr A., Leonard J. M., Lehman L. M., Gudiol F., Gonzales J., Raventos A., Rubio R., Bouza E., Pintado V. A short-term study of the safety, pharmacokinetics, and efficacy of ritonavir, an inhibitor of HIV-1 protease. European-Australian Collaborative Ritonavir Study Group. N Engl J Med. 1995 Dec 7;333(23):1528–1533. doi: 10.1056/NEJM199512073332303. [DOI] [PubMed] [Google Scholar]
  7. Dewar R. L., Highbarger H. C., Sarmiento M. D., Todd J. A., Vasudevachari M. B., Davey R. T., Jr, Kovacs J. A., Salzman N. P., Lane H. C., Urdea M. S. Application of branched DNA signal amplification to monitor human immunodeficiency virus type 1 burden in human plasma. J Infect Dis. 1994 Nov;170(5):1172–1179. doi: 10.1093/infdis/170.5.1172. [DOI] [PubMed] [Google Scholar]
  8. Eastman P. S., Urdea M., Besemer D., Stempien M., Kolberg J. Comparison of selective polymerase chain reaction primers and differential probe hybridization of polymerase chain reaction products for determination of relative amounts of codon 215 mutant and wild-type HIV-1 populations. J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Jul 1;9(3):264–273. [PubMed] [Google Scholar]
  9. Henderson J. T., Benight A. S., Hanlon S. A semi-micromethod for the determination of the extinction coefficients of duplex and single-stranded DNA. Anal Biochem. 1992 Feb 14;201(1):17–29. doi: 10.1016/0003-2697(92)90169-8. [DOI] [PubMed] [Google Scholar]
  10. Henrard D. R., Phillips J. F., Muenz L. R., Blattner W. A., Wiesner D., Eyster M. E., Goedert J. J. Natural history of HIV-1 cell-free viremia. JAMA. 1995 Aug 16;274(7):554–558. [PubMed] [Google Scholar]
  11. Ho D. D., Neumann A. U., Perelson A. S., Chen W., Leonard J. M., Markowitz M. Rapid turnover of plasma virions and CD4 lymphocytes in HIV-1 infection. Nature. 1995 Jan 12;373(6510):123–126. doi: 10.1038/373123a0. [DOI] [PubMed] [Google Scholar]
  12. Hogervorst E., Jurriaans S., de Wolf F., van Wijk A., Wiersma A., Valk M., Roos M., van Gemen B., Coutinho R., Miedema F. Predictors for non- and slow progression in human immunodeficiency virus (HIV) type 1 infection: low viral RNA copy numbers in serum and maintenance of high HIV-1 p24-specific but not V3-specific antibody levels. J Infect Dis. 1995 Apr;171(4):811–821. doi: 10.1093/infdis/171.4.811. [DOI] [PubMed] [Google Scholar]
  13. Holodniy M., Mole L., Winters M., Merigan T. C. Diurnal and short-term stability of HIV virus load as measured by gene amplification. J Acquir Immune Defic Syndr. 1994 Apr;7(4):363–368. [PubMed] [Google Scholar]
  14. Lin H. J., Myers L. E., Yen-Lieberman B., Hollinger F. B., Henrard D., Hooper C. J., Kokka R., Kwok S., Rasheed S., Vahey M. Multicenter evaluation of quantification methods for plasma human immunodeficiency virus type 1 RNA. J Infect Dis. 1994 Sep;170(3):553–562. doi: 10.1093/infdis/170.3.553. [DOI] [PubMed] [Google Scholar]
  15. Loveday C., Hill A. Prediction of progression to AIDS with serum HIV-1 RNA and CD4 count. Lancet. 1995 Mar 25;345(8952):790–791. doi: 10.1016/s0140-6736(95)90668-1. [DOI] [PubMed] [Google Scholar]
  16. Markowitz M., Saag M., Powderly W. G., Hurley A. M., Hsu A., Valdes J. M., Henry D., Sattler F., La Marca A., Leonard J. M. A preliminary study of ritonavir, an inhibitor of HIV-1 protease, to treat HIV-1 infection. N Engl J Med. 1995 Dec 7;333(23):1534–1539. doi: 10.1056/NEJM199512073332204. [DOI] [PubMed] [Google Scholar]
  17. Mellors J. W., Kingsley L. A., Rinaldo C. R., Jr, Todd J. A., Hoo B. S., Kokka R. P., Gupta P. Quantitation of HIV-1 RNA in plasma predicts outcome after seroconversion. Ann Intern Med. 1995 Apr 15;122(8):573–579. doi: 10.7326/0003-4819-122-8-199504150-00003. [DOI] [PubMed] [Google Scholar]
  18. Mulder J., McKinney N., Christopherson C., Sninsky J., Greenfield L., Kwok S. Rapid and simple PCR assay for quantitation of human immunodeficiency virus type 1 RNA in plasma: application to acute retroviral infection. J Clin Microbiol. 1994 Feb;32(2):292–300. doi: 10.1128/jcm.32.2.292-300.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Pachl C., Todd J. A., Kern D. G., Sheridan P. J., Fong S. J., Stempien M., Hoo B., Besemer D., Yeghiazarian T., Irvine B. Rapid and precise quantification of HIV-1 RNA in plasma using a branched DNA signal amplification assay. J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Apr 15;8(5):446–454. doi: 10.1097/00042560-199504120-00003. [DOI] [PubMed] [Google Scholar]
  20. Piatak M., Jr, Saag M. S., Yang L. C., Clark S. J., Kappes J. C., Luk K. C., Hahn B. H., Shaw G. M., Lifson J. D. High levels of HIV-1 in plasma during all stages of infection determined by competitive PCR. Science. 1993 Mar 19;259(5102):1749–1754. doi: 10.1126/science.8096089. [DOI] [PubMed] [Google Scholar]
  21. Running J. A., Urdea M. S. A procedure for productive coupling of synthetic oligonucleotides to polystyrene microtiter wells for hybridization capture. Biotechniques. 1990 Mar;8(3):276–279. [PubMed] [Google Scholar]
  22. Sanchez-Pescador R., Power M. D., Barr P. J., Steimer K. S., Stempien M. M., Brown-Shimer S. L., Gee W. W., Renard A., Randolph A., Levy J. A. Nucleotide sequence and expression of an AIDS-associated retrovirus (ARV-2). Science. 1985 Feb 1;227(4686):484–492. doi: 10.1126/science.2578227. [DOI] [PubMed] [Google Scholar]
  23. Semple M., Loveday C., Weller I., Tedder R. Direct measurement of viraemia in patients infected with HIV-1 and its relationship to disease progression and zidovudine therapy. J Med Virol. 1991 Sep;35(1):38–45. doi: 10.1002/jmv.1890350109. [DOI] [PubMed] [Google Scholar]
  24. Todd J., Pachl C., White R., Yeghiazarian T., Johnson P., Taylor B., Holodniy M., Kern D., Hamren S., Chernoff D. Performance characteristics for the quantitation of plasma HIV-1 RNA using branched DNA signal amplification technology. J Acquir Immune Defic Syndr Hum Retrovirol. 1995;10 (Suppl 2):S35–S44. [PubMed] [Google Scholar]
  25. Urdea M. S., Horn T., Fultz T. J., Anderson M., Running J. A., Hamren S., Ahle D., Chang C. A. Branched DNA amplification multimers for the sensitive, direct detection of human hepatitis viruses. Nucleic Acids Symp Ser. 1991;(24):197–200. [PubMed] [Google Scholar]
  26. Urdea M. S., Warner B. D., Running J. A., Stempien M., Clyne J., Horn T. A comparison of non-radioisotopic hybridization assay methods using fluorescent, chemiluminescent and enzyme labeled synthetic oligodeoxyribonucleotide probes. Nucleic Acids Res. 1988 Jun 10;16(11):4937–4956. doi: 10.1093/nar/16.11.4937. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Warshaw M. M., Tinoco I., Jr Optical properties of sixteen dinucleoside phosphates. J Mol Biol. 1966 Sep;20(1):29–38. doi: 10.1016/0022-2836(66)90115-x. [DOI] [PubMed] [Google Scholar]
  28. Webb M. R. A continuous spectrophotometric assay for inorganic phosphate and for measuring phosphate release kinetics in biological systems. Proc Natl Acad Sci U S A. 1992 Jun 1;89(11):4884–4887. doi: 10.1073/pnas.89.11.4884. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Weber J., Galpin S. HIV results in the frame. Cyclosporin A. Nature. 1995 May 18;375(6528):198–198. doi: 10.1038/375198a0. [DOI] [PubMed] [Google Scholar]
  30. Wei X., Ghosh S. K., Taylor M. E., Johnson V. A., Emini E. A., Deutsch P., Lifson J. D., Bonhoeffer S., Nowak M. A., Hahn B. H. Viral dynamics in human immunodeficiency virus type 1 infection. Nature. 1995 Jan 12;373(6510):117–122. doi: 10.1038/373117a0. [DOI] [PubMed] [Google Scholar]

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