QUANTIFICATION OF HIV-1 RNA IN PLASMA USING NASBA (TM) DURING HIV-1 PRIMARY INFECTION

Quantification of HIV-1 viral RNA in plasma was achieved by competitiv e co-amplification of a dilution series of in vitro generated RNA usin g the nucleic acid sequence based amplification (NASBA(TM)) technology . This 1.5 kilobase in vitro RNA, comprising the gag and part of the p ol region, differs only by sequence-randomization of a 20 nt fragment from the wild-type RNA, ensuring equal efficiency of amplification. In model systems the accuracy of this method is within one log. Applicat ion of the Q-NASBA to plasma samples of a patient with a primary HIV-1 infection shows good concordance of the HIV-1 RNA profile with the p2 4 antigen profile. However, the HIV-1 RNA determination is more sensit ive than the p24 antigen determination. Peak values of HIV-1 RNA are a round 108 RNA molecules per ml plasma at the moment of seroconversion. Quantitative nucleic acid detection methods, like Q-NASBA, allow the monitoring of HIV-1 RNA during the course of infection which might hav e predictive value for disease development.