Quantitation of HIV-1 Viral RNA in Blood Plasma and Genital Secretions
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Quantitation of HIV RNA in blood is commonly used to monitor progression of the disease and to assess the effect of antiretroviral therapy in individuals. Although not approved in the US for diagnosis of HIV infection, the finding of a positive HIV RNA with a negative HIV enzyme immunoassay and Western blot (or evolving Western blot) is an indication of primary HIV infection and should be followed up closely. Large clinical trials and cohort studies have demonstrated the importance of HIV RNA as an indicator of drug efficacy and as a factor in HIV transmission.
Sexual intercourse is the most common method of transmission of HIV-1. Several studies have demonstrated that blood plasma viral load is significantly correlated with the risk of sexual HIV transmission. Additional investigations have found a significant correlation between the viral load in blood plasma and in the genital tract. This chapter describes methods of collection, processing, and testing in blood, plasma, and male and female genital secretions for quantifying HIV RNA.
