Monitoring Atypical HIV Strains Among Persons Newly Dia*

描述(由申请人提供)： 在过去的二十年里，艾滋病报告已经成为美国艾滋病毒相关疾病公共卫生监测的核心。最近，所有州也实施了某种形式的艾滋病毒报告。然而，随着预防工作的进展、人们对该流行病的国际特征的认识的提高以及联合抗逆转录病毒疗法导致的疾病临床病程的变化，对艾滋病毒发病率以及非典型和抗逆转录病毒(ARV)耐药株的监测数据的必要性变得越来越明显。目前的实验室经验表明，使用诊断血清进行更广泛的监测是可行的。用血清或口服液进行艾滋病毒确证检测的另一种可能允许扩大监测的方法是使用干血迹(DBS)进行艾滋病毒确证检测。DBS可以由只接受过最少技术培训的个人制作，他们使用一次性柳叶刀在手指上造成一个精确的伤口，从中可以将几滴血吸收到专门准备的滤纸上。这项应用的目的是发展实验室专门知识和获得现场经验，利用DBS监测新诊断人员中的非典型和抗抗ARV艾滋病毒毒株。 此应用程序的具体目标包括：1)通过血清和DBS的配对比较，验证DBS非典型/抗逆转录病毒株检测的方法学；2)确定在临床环境下获得DBS和DBS所需的可行性和所需资源；3)确定商业实验室从抽血中制备DBS用于临床诊断或预后检测的可行性和所需资源；4)监测非典型/抗逆转录病毒株的流行情况；以及5)比较使用DBS进行这种监测的地点和使用血清的非典型/ARV耐药株的流行率。

DESCRIPTION (provided by applicant): Over the last two decades, AIDS reporting has formed the core of public health surveillance for HIV-related disease in the United States. More recently, all states have implemented some form of HIV reporting as well. However, the need for surveillance data on HIV incidence and atypical and antiretroviral (ARV) resistant strains has become increasingly apparent with advances in prevention, increased awareness of the international characteristics of the epidemic, and changes in the clinical course of the disease due to combination ARV therapy. Current laboratory experience would indicate that use of diagnostic sera for more expanded surveillance is feasible. An alternative to HIV confirmatory testing with sera or oral fluid that will potentially allow expanded surveillance is that of confirmatory HIV testing using dried blood spots (DBS). DBS can be prepared by individuals with minimal technical training who use a disposable lancet to create a pinpoint wound in the finger from which a few drops of blood can be absorbed onto specially prepared filter paper. The purpose of this application is to develop laboratory expertise and acquire field experience in using DBS for atypical and ARV resistant HIV strain surveillance in newly diagnosed persons. The specific aims of this application include: 1) Validate methodology for DBS atypical/ ARV resistant strain testing through paired comparison of sera and DBS; 2) Determine the feasibility and resources required to obtain DBS versus sera in clinical settings; 3) Determine the feasibility and resources required for commercial laboratories to prepare DBS from blood drawn for clinically indicated diagnostic or prognostic tests; 4) Monitor the prevalence of atypical/ARV resistant strains; and 5) Compare atypical/ARV resistant strain prevalence in sites using DBS for this surveillance versus those using sera.