Table 3.
Meta-Analysis of the Clinical Metrics Overall and for Each Viral Load Technology
| All Technologies | Abbott RealTime HIV-1 | Biocentric Generic HIV Charge Virale |
bioMerieux NucliSENS EasyQ HIV-1 |
Hologic Aptima | Roche Amplicor HIV-1 | Roche COBAS TaqMan HIV-1 | ||
| n | 1847 | 245 | 148 | 183 | 40 | 154 | 1077 | |
| Dried plasma spot:median viral load (log10 copies/mL) | 0.10 | 4.42 | 4.12 | 0 | 2.99 | 4.01 | 0 | |
| Plasma: median viral load (log10 copies/mL) | 2.35 | 3.67 | 4.22 | 0 | 3.44 | 4.44 | 1.67 | |
| Difference in medians (log10 copies/mL) | 2.25 | –0.75 | 0.1 | 0 | 0.45 | 0.43 | 1.67 | |
| Mean bias (log10 copies/mL) | 0.28 | –0.36 | 0.3 | 0.18 | 1.27 | 0.38 | 0.39 | |
| DBS:plasma threshold comparisons | ||||||||
| Sensitivity (UCL—LCL) |
1000:1000 | 92.27 (87.58–95.28) | 99.39 (95.78–99.91) | 98.12 (56.78–99.95) | 77.78 (53.53–91.40) | 86.96 (66.45–95.73) | 92.07 (78.12–97.42) | 93.05 (87.75–96.16) |
| 800:800 | 93.72 (88.64–96.61) | 99.40 (95.85–99.92) | 98.13 (43.27–99.97) | 84.21 (60.85–94.82) | 91.30 (71.11–97.82) | 90.42 (79.02–95.94) | 93.91 (88.66–96.82) | |
| 600:600 | 94.55 (90.01–97.10) | 98.82 (95.42–99.71) | 98.13 (44.03–99.97) | 84.21 (60.85–94.82) | 87.50 (67.62–95.91) | 91.94 (85.66–95.61) | 96.55 (89.36–98.94) | |
| 500:500 | 94.39 (89.47–97.09) | 98.84 (95.47–99.71) | 98.13 (44.03–99.97) | 80.00 (57.21–92.29) | 84.00 (64.31–93.86) | 91.94 (85.66–95.61) | 96.85 (89.39–99.12) | |
| 400:400 | 94.03 (88.97–96.85) | 98.84 (95.47–99.71) | 98.13 (33.64–99.98) | 76.19 (53.97–89.73) | 84.00 (64.31–93.86) | 92.74 (86.64–96.18) | 95.98 (88.40–98.68) | |
| 200:200 | 93.67 (87.39–96.93) | 98.87 (95.60–99.72) | 98.14 (29.57–99.98) | 66.67 (46.12–82.37) | 77.78 (58.55–89.66) | 92.00 (85.77–95.64) | 95.58 (84.87–98.81) | |
| Detectable | 97.06 (87.41–99.37) | 97.83 (61.21–99.92) | — | 88.53 (17.23–99.65) | — | 93.65 (87.82–96.79) | 99.79 (57.43–100.00) | |
| Specificity (UCL–LCL) |
1000:1000 | 95.57 (88.48–98.37) | 85.37 (75.97–91.50) | 75.00 (46.90–91.06) | 99.39 (95.83–99.91) | 100.00 (0.00–100.00) | 95.56 (68.84–99.53) | 94.90 (78.59–98.95) |
| 800:800 | 96.64 (89.79–98.95) | 88.61 (79.53–93.96) | 76.19 (1.90–99.81) | 99.39 (95.80–99.91) | 100.00 (0.00–100.00) | 95.05 (67.97–99.43) | 95.33 (78.11–99.15) | |
| 600:600 | 97.11 (91.66–99.04) | 90.67 (81.69–95.49) | 74.99 (5.74–99.33) | 99.39 (95.80–99.91) | 100.00 (0.00–100.00) | 93.33 (76.93–98.33) | 98.05 (92.57–99.51) | |
| 500:500 | 97.16 (91.80–99.05) | 93.15 (84.58–97.12) | 74.99 (5.74–99.33) | 99.39 (95.78–99.91) | 100.00 (0.00–100.00) | 93.33 (76.93–98.33) | 98.00 (92.97–99.45) | |
| 400:400 | 96.51 (90.22–98.80) | 93.15 (84.58–97.12) | 72.22 (0.40–99.94) | 99.38 (95.75–99.91) | 100.00 (0.00–100.00) | 93.33 (76.93–98.33) | 97.24 (93.26–98.90) | |
| 200:200 | 97.53 (92.46–99.22) | 100.00 (0.00–100.00) | 70.56 (0.19–99.97) | 99.37 (95.67–99.91) | 100.00 (0.00–100.00) | 93.10 (76.25–98.27) | 97.22 (93.59–98.82) | |
| Detectable | 98.69 (95.03–99.66) | 100.00 (0.00–100.00) | — | 99.32 (23.05–100.00) | — | 92.86 (75.52–98.21) | 99.14 (92.67–99.90) | |
| Total misclassification (UCL–LCL) | 1000:1000 | 5.36 (3.26–8.69) | 5.31 (3.11–8.92) | 1.88 (0.02–64.28) | 2.73 (1.14–6.39) | 7.50 (2.44–20.82) | 7.69 (3.23–17.24) | 4.86 (3.28–7.13) |
| 800:800 | 4.73 (2.69–8.19) | 4.08 (2.21–7.42) | 1.87 (0.02–68.29) | 2.19 (0.82–5.68) | 5.00 (1.25–17.91) | 9.08 (5.23–15.28) | 3.94 (2.16–7.08) | |
| 600:600 | 4.18 (2.23–7.70) | 3.67 (1.92–6.91) | 1.87 (0.02–68.28) | 2.19 (0.82–5.68) | 7.50 (2.44–20.82) | 7.79 (4.48–13.22) | 2.61 (0.86–7.65) | |
| 500:500 | 4.31 (2.34–7.79) | 2.86 (1.37–5.87) | 1.87 (0.02–68.28) | 2.73 (1.14–6.39) | 10.00 (3.80–23.79) | 7.79 (4.48–13.22) | 2.58 (0.85–7.52) | |
| 400:400 | 4.77 (2.80–8.02) | 2.86 (1.37–5.87) | 1.87 (0.01–74.96) | 3.28 (1.48–7.10) | 10.00 (3.80–23.79) | 7.14 (4.00–12.44) | 3.49 (1.49–7.95) | |
| 200:200 | 4.76 (2.68–8.33) | 0.82 (0.20–3.20) | 1.87 (0.01–77.81) | 4.92 (2.58–9.18) | 15.00 (6.90–29.59) | 7.79 (4.48–13.22) | 4.02 (1.66–9.40) | |
| Detectable | 2.81 (0.86–8.76) | 1.86 (0.07–35.25) | — | 6.01 (3.36–10.53) | — | 6.49 (3.53–11.65) | 0.60 (0.02–13.62) | |
| Upward Misclassification (UCL–LCL) | 1000:1000 | 4.43 (1.63–11.52) | 14.63 (8.50–24.03) | 25.00 (8.94–53.10) | 0.61 (0.09–4.17) | 0.00 (0.00–100.00) | 4.44 (0.47–31.16) | 5.10 (1.05–21.41) |
| 800:800 | 3.36 (1.05–10.21) | 11.39 (6.04–20.47) | 23.81 (0.19–98.10) | 0.61 (0.09–4.20) | 0.00 (0.00–100.00) | 4.95 (0.57–32.03) | 4.67 (0.85–21.89) | |
| 600:600 | 2.89 (0.96–8.34) | 9.33 (4.51–18.31) | 25.01 (0.67–94.26) | 0.61 (0.09–4.20) | 0.00 (0.00–100.00) | 6.67 (1.67–23.07) | 1.95 (0.49–7.43) | |
| 500:500 | 2.84 (0.95–8.20) | 6.85 (2.88–15.42) | 25.01 (0.67–94.26) | 0.61 (0.09–4.22) | 0.00 (0.00–100.00) | 6.67 (1.67–23.07) | 2.00 (0.55–7.03) | |
| 400:400 | 3.49 (1.20–9.78) | 6.85 (2.88–15.42) | 27.78 (0.06–99.60) | 0.62 (0.09–4.25) | 0.00 (0.00–100.00) | 6.67 (1.67–23.07) | 2.76 (1.10–6.74) | |
| 200:200 | 2.47 (0.78–7.54) | 0.00 (0.00–100.00) | 29.44 (0.03–99.81) | 0.63 (0.09–4.33) | 0.00 (0.00–100.00) | 6.90 (1.73–23.75) | 2.78 (1.18–6.41) | |
| Detectable | 1.31 (0.34–4.97) | 0.00 (0.00–100.00) | — | 0.68 (0.00–76.95) | — | 7.14 (1.79–24.48) | 0.86 (0.10–7.33) | |
| Downward misclassification (UCL–LCL) | 1000:1000 | 7.73 (4.72–12.42) | 0.61 (0.09–4.22) | 1.88 (0.05–43.22) | 22.22 (8.60–46.47) | 13.04 (4.27–33.55) | 7.93 (2.58–21.88) | 6.95 (3.84–12.25) |
| 800:800 | 6.28 (3.39–11.36) | 0.60 (0.08–4.15) | 1.87 (0.03–56.73) | 15.79 (5.18–39.15) | 8.70 (2.18–28.89) | 9.58 (4.06–20.98) | 6.09 (3.18–11.34) | |
| 600:600 | 5.45 (2.90–9.99) | 1.18 (0.29–4.58) | 1.87 (0.03–55.97) | 15.79 (5.18–39.15) | 12.50 (4.09–32.38) | 8.06 (4.39–14.34) | 3.45 (1.06–10.64) | |
| 500:500 | 5.61 (2.91–10.53) | 1.16 (0.29–4.53) | 1.87 (0.03–55.97) | 20.00 (7.71–42.79) | 16.00 (6.14–35.69) | 8.06 (4.39–14.34) | 3.15 (0.88–10.61) | |
| 400:400 | 5.97 (3.15–11.03) | 1.16 (0.29–4.53) | 1.87 (0.02–66.36) | 23.81 (10.27–46.03) | 16.00 (6.14–35.69) | 7.26 (3.82–13.36) | 4.02 (1.32–11.60) | |
| 200:200 | 6.33 (3.07–12.61) | 1.13 (0.28–4.40) | 1.86 (0.02–70.43) | 33.33 (17.63–53.88) | 22.22 (10.34–41.45) | 8.00 (4.36–14.23) | 4.42 (1.19–15.13) | |
| Detectable | 2.94 (0.63–12.59) | 2.17 (0.08–38.79) | — | 11.47 (0.35–82.77) | — | 6.35 (3.21–12.18) | 0.21 (0.00–42.57) | |
| PPV (UCL–LCL) | 1000:1000 | 96.21 (92.49–98.12) | 93.10 (88.25–96.04) | 98.12 (56.80–99.95) | 93.33 (64.80–99.07) | 100.00 (0.00–100.00) | 98.87 (86.34–99.92) | 95.39 (87.86–98.34) |
| 800:800 | 97.08 (93.51–98.72) | 94.83 (90.36–97.29) | 98.10 (66.38–99.93) | 94.12 (67.97–99.18) | 100.00 (0.00–100.00) | 98.88 (85.95–99.92) | 95.75 (87.35–98.66) | |
| 600:600 | 98.03 (94.16–99.36) | 96.00 (91.85–98.08) | 98.10 (67.06–99.92) | 94.12 (67.97–99.18) | 100.00 (0.00–100.00) | 98.70 (98.67–98.73) | 97.69 (88.15–99.59) | |
| 500:500 | 98.19 (94.50–99.42) | 97.14 (93.32–98.81) | 98.10 (67.06–99.92) | 94.12 (67.97–99.18) | 100.00 (0.00–100.00) | 98.70 (98.67–98.73) | 97.79 (88.27–99.62) | |
| 400:400 | 97.77 (94.38–99.14) | 97.14 (93.32–98.81) | 98.10 (67.06–99.92) | 94.12 (67.97–99.18) | 100.00 (0.00–100.00) | 98.37 (85.38–99.84) | 96.74 (89.11–99.08) | |
| 200:200 | 98.48 (95.55–99.49) | 100.00 (0.00–100.00) | 98.10 (67.06–99.92) | 94.12 (67.97–99.18) | 100.00 (0.00–100.00) | 98.84 (86.15–99.91) | 96.81 (89.60–99.07) | |
| Detectable | 99.81 (96.59–99.99) | 100.00 (0.00–100.00) | — | 96.30 (77.92–99.48) | — | 98.33 (93.58–99.58) | 99.68 (82.86–99.99) | |
| NPV (UCL–LCL) | 1000:1000 | 88.28 (75.84–94.75) | 98.59 (90.67–99.80) | 75.00 (46.90–91.06) | 97.62 (93.83–99.10) | 85.00 (62.42–95.08) | 74.57 (51.94–88.84) | 93.67 (85.44–97.39) |
| 800:800 | 90.43 (76.37–96.51) | 98.59 (90.67–99.80) | 66.67 (37.52–86.95) | 98.19 (94.55–99.42) | 89.47 (66.26–97.35) | 69.26 (49.13–84.02) | 95.22 (85.77–98.50) | |
| 600:600 | 90.85 (73.41–97.28) | 97.14 (89.29–99.28) | 65.22 (30.04–89.11) | 98.19 (94.55–99.42) | 84.21 (60.85–94.82) | 72.49 (72.02–72.95) | 95.96 (78.64–99.35) | |
| 500:500 | 90.35 (73.18–96.98) | 97.14 (89.29–99.28) | 65.22 (30.04–89.11) | 97.59 (93.76–99.09) | 78.95 (55.45–91.87) | 72.49 (72.02–72.95) | 95.99 (79.82–99.31) | |
| 400:400 | 89.67 (72.15–96.67) | 97.14 (89.29–99.28) | 56.52 (24.25–84.07) | 96.99 (92.97–98.74) | 78.95 (55.45–91.87) | 75.48 (56.72–87.84) | 95.20 (77.18–99.15) | |
| 200:200 | 87.71 (68.53–95.90) | 97.14 (89.29–99.28) | 52.17 (25.77–77.41) | 95.18 (90.66–97.57) | 68.42 (45.16–85.08) | 71.13 (50.46–85.63) | 94.02 (67.87–99.15) | |
| Detectable | 15.78 (0.43–89.06) | 18.96 (0.05–99.04) | — | 93.59 (88.50–96.52) | — | 76.47 (59.54–87.77) | 0.51 (0.00–99.85) |
LCL, lower confidence limit; UCL, upper confidence limit.