Less sensitive HIV-1 enzyme immunoassay as an adjuvant method for monitoring patients receiving antiretroviral therapy

Viral suppression after antiretroviral therapy is monitored by determining plasma HIV-1 through viral load assays. However, such assays only provide HIV-1 replication rates at the moment samples are drawn and do not reflect any trend in viremia fluctuation preceding sample collection. The objective of this study was to correlate the optical density (OD) of the less sensitive HIV-1 enzyme immunoassay (EIA), used in the serologic testing algorithm for recent HIV seroconversion, with viral loads in a group of HIV-infected patients on antiretroviral therapy. We studied samples from 20 previously antiretroviral-naive subjects treated with the zidovudine-lamivudine combination plus indinavir for a 20-week period. Viral loads were assessed using the less sensitive HIV-1 EIA at baseline and at 4-week intervals. There was a strong correlation between lower OD and viral load after introduction of antiretroviral drugs (p < 0.01). The ODs tended to decrease in parallel with drops in viral loads and remain steady when viral loads did not change significantly. These results suggest that the less sensitive HIV-1 EIA may be used as a complementary method for monitoring the efficacy of antiretroviral therapy, with special appeal in resource-poor areas where health professionals have limited laboratory expertise.