1
|
Gutema G, Hailu H, W/semeyat B, Yilma A, Abdela S, Kidane E, Adane S, Yimer M, Tsegaye A. Effect of sample management on quantitative HIV-1 viral load measurement at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. PLoS One 2022; 17:e0269943. [PMID: 35700178 PMCID: PMC9197020 DOI: 10.1371/journal.pone.0269943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 06/01/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose This study was meant to determine the effect of time to plasma separation, storage duration, freeze-thawing cycle and dilution proportion on the HIV-1 viral load level. Methods Experimental study design was employed by collecting 10mL whole blood samples into two EDTA tubes from 88 eligible HIV infected patients at St Paul’s Hospital Millennium Medical College. The viral load test was done using Abbott m2000sp/rt analyzer. Data was entered into Microsoft excel and analyzed by SPSS version 20. Repeated measure analysis of variance was used to compare HIV RNA viral load mean difference between different time to plasma separation, storage, freeze-thawing cycles and dilution levels. Post-hoc analysis was employed to locate the place of significant differences. P value less than 0.05 was used to declare statistical significance while viral RNA level of 0.5 log copies/ml was used to determine clinical significance. Results There was significant HIV-1 RNA viral load log mean difference between plasma separation time at 6 hours (hrs) and 24hrs (p<0.001). There was also significant HIV-1 RNA viral load log mean difference between plasma tested within 6hrs and those stored at 2–8°C for 15 days (p = 0.006), and between plasma stored at 2–8°C for 6 days versus 15 days (p<0.001). There was significant log mean difference between plasma that was exposed to fourth cycle of freeze-thawing after storage at -20°C when compared with plasma tested within 6hrs (p = 0.013). Conclusion Plasma separated at 24hrs, stored at 2–8°C for 15 days or freeze-thawed for four cycles had significant effect on HIV viral load level. However, the differences were not clinically significant at a cut-off viral load level of 0.5 log copies/ml. Avoiding delays to plasma separation beyond 24 hrs, storing at 2–8°C for 15 days and freeze-thawing for no more than 4 cycles is recommended to improve the result quality.
Collapse
Affiliation(s)
- Gadissa Gutema
- HIV/AIDS Disease Research Team, TB and HIV/AIDS Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Habtyes Hailu
- TB Disease Research Team, TB and HIV/AIDS Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Belete W/semeyat
- HIV/AIDS Disease Research Team, TB and HIV/AIDS Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Amelework Yilma
- HIV/AIDS Disease Research Team, TB and HIV/AIDS Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Saro Abdela
- HIV/AIDS Disease Research Team, TB and HIV/AIDS Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Eleni Kidane
- HIV/AIDS Disease Research Team, TB and HIV/AIDS Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Sisay Adane
- HIV/AIDS Disease Research Team, TB and HIV/AIDS Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mengistu Yimer
- HIV/AIDS Disease Research Team, TB and HIV/AIDS Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Aster Tsegaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
2
|
Tola M, Habib RO, Sylvia A, Crowell TA, Rebecca NG, Charurat ME, Dakum P, Ndembi N. Field evaluation of HIV-1 viral load monitoring in adults and children receiving antiretroviral treatment in Nigeria by dried blood spot testing with RealTime HIV-1 on m2000. J Clin Virol 2021; 135:104694. [PMID: 33476928 DOI: 10.1016/j.jcv.2020.104694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 11/11/2020] [Accepted: 11/15/2020] [Indexed: 10/22/2022]
Abstract
In resource-limited settings, use of dried blood spots (DBS) could be a pragmatic alternative to plasma for VL monitoring in people living with HIV (PLWH). We compared results from DBS to standard plasma VL testing under field conditions in patients receiving antiretroviral therapy (ART). DBS cards were prepared from venous blood (V-DBS), finger-pricks using micro-capillary tubes (M-DBS), and direct spotting (D-DBS). DBS and matched EDTA plasma were tested on the Abbott m2000 platform using the appropriate RealTime HIV-1 quantitative CE protocol. Matched plasma samples were also tested on the Roche COBAS Ampliprep/COBAS TaqMan version 2.0. Diagnostic accuracy indicators (sensitivity, specificity, misclassification rate, and kappa coefficient) for viral failure (VF) based on different VL threshold levels and agreement of absolute VL were calculated. A total of 669 participants provided 2676 samples. V-DBS had a peak sensitivity for VF of 89.1 % [95 % CI: 85.5-92.7] at the 1000 copies/mL threshold and a peak specificity of 97.4 % [95 % CI: 95.9-99.0] at the 5000 copies/mL threshold. The lowest proportion of upward misclassification (patients classified with VF who actually had viral suppression) for V-DBS was 3.1 % [95 % CI: 1.4-4.8] at the 5000 copies/mL threshold, whereas the lowest proportion of downward misclassification (patients classified as undetectable who actually had VF) was 10.9 % [95 % CI: 7.2-14.5] at the 1000 copies/mL threshold. Abbott RealTime HIV-1 VL results from all 3 DBS types for adults and children showed strong correlation with the gold standard plasma-based assay. DBS could be useful for monitoring VL in resource limited settings such as Nigeria.
Collapse
Affiliation(s)
- Monday Tola
- Institute of Human Virology Nigeria, Abuja, Federal Capital Territory, Nigeria
| | - Ramadhani O Habib
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Adebajo Sylvia
- Maryland Global Initiatives Corporation, University of Maryland, Nigeria
| | - Trevor A Crowell
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA; U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Nowak G Rebecca
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Manhattan E Charurat
- Institute of Human Virology Nigeria, Abuja, Federal Capital Territory, Nigeria; Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Patrick Dakum
- Institute of Human Virology Nigeria, Abuja, Federal Capital Territory, Nigeria; Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Nicaise Ndembi
- Institute of Human Virology Nigeria, Abuja, Federal Capital Territory, Nigeria; Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA; Africa Centers for Disease Control and Prevention (Africa CDC), African Union Commission, Addis Ababa, Ethiopia; Kanazawa University, Graduate Medical Sciences, Kanazawa, Japan.
| |
Collapse
|
3
|
Newman H, Hardie D. HIV-1 viral load testing in resource-limited settings: Challenges and solutions for specimen integrity. Rev Med Virol 2020; 31:e2165. [PMID: 32978882 DOI: 10.1002/rmv.2165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/20/2020] [Accepted: 08/22/2020] [Indexed: 11/07/2022]
Abstract
HIV-1 viral load (VL) testing is a crucial element in providing an antiretroviral treatment monitoring program. The success of these programs depends on the availability and quality of the VL testing services. There are several pre-analytic factors which can affect the quality of VL testing. Many of the challenges faced by resource-limited countries result in a compromise of specimen integrity, thus limiting widespread access to VL monitoring. The various logistic and financial challenges that exist are not insurmountable and several innovative solutions currently exist to overcome these barriers to providing widespread VL testing. This review summarizes the VL testing challenges in resource-limited settings and provides an overview of potential solutions including testing dried blood spots, dried plasma spots, plasma separation cards and the use of point of care tests.
Collapse
Affiliation(s)
- Howard Newman
- National Health Laboratory Service, South Africa.,Department of Pathology, Division of Medical Virology, Stellenbosch University, Stellenbosch, South Africa.,Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| | - Diana Hardie
- National Health Laboratory Service, South Africa.,Department of Pathology, Division of Virology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
4
|
Luo R, Markby J, Sacks J, Vojnov L. Systematic review of the accuracy of plasma preparation tubes for HIV viral load testing. PLoS One 2019; 14:e0225393. [PMID: 31751392 PMCID: PMC6874077 DOI: 10.1371/journal.pone.0225393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 11/03/2019] [Indexed: 01/28/2023] Open
Abstract
Expanding access to HIV viral load testing is essential to improving the care and treatment of people living with HIV/AIDS and ending the AIDS epidemic. Though significant investments have been made in the past five years, many high burden, low resource countries continue to have viral load access rates below 50%. Plasma preparation tubes (PPTs) can simplify storage, transport, and preparation of plasma used for viral load testing. A systematic review was conducted to evaluate the accuracy of plasma preparation tubes for HIV viral load testing. Study results regarding the accuracy of PPT viral load measurements across various storage and transportation conditions were examined. The quality of evidence was evaluated using GRADE and QUADAS-2 criteria. The review identified 16 studies using PPTs with data from 6,141 individuals from 1995 to 2014. Overall the quality of evidence was rated as moderate, with unclear applicability for studies evaluating viral load assays that are no longer commercially available. Significantly elevated viral load results (>0.3 log copies/ml difference) have been observed with PPTs; however, when manufacturer handling instructions are followed, when plasma is aliquoted into a secondary tube, or when PPTs are centrifuged prior to testing, PPT results only differed from standard EDTA plasma testing using commercially available viral load assays by a range on average of -0.03 to +0.08 log copies/ml across studies. Although spuriously elevated viral load results have been observed with PPTs, following proper sample handing techniques have been shown to provide accurate results. PPTs, therefore, provide a high quality alternative specimen type for countries seeking solutions to infrastructure and specimen transportation challenges in an effort to scale-up viral load testing and achieve 90-90-90 targets.
Collapse
Affiliation(s)
- Robert Luo
- World Health Organization, Geneva, Switzerland
- * E-mail:
| | - Jessica Markby
- Clinton Health Access Initiative, Boston, Massachusetts, United States of America
| | - Jilian Sacks
- Clinton Health Access Initiative, Boston, Massachusetts, United States of America
| | - Lara Vojnov
- World Health Organization, Geneva, Switzerland
| |
Collapse
|
5
|
Farzan VM, Kvach MV, Aparin IO, Kireev DE, Prikazchikova TA, Ustinov AV, Shmanai VV, Shipulin GA, Korshun VA, Zatsepin TS. Novel homo Yin-Yang probes improve sensitivity in RT-qPCR detection of low copy HIV RNA. Talanta 2019; 194:226-232. [DOI: 10.1016/j.talanta.2018.10.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 10/09/2018] [Accepted: 10/11/2018] [Indexed: 12/31/2022]
|
6
|
Tang N, Pahalawatta V, Frank A, Bagley Z, Viana R, Lampinen J, Leckie G, Huang S, Abravaya K, Wallis CL. HIV-1 viral load measurement in venous blood and fingerprick blood using Abbott RealTime HIV-1 DBS assay. J Clin Virol 2017; 92:56-61. [PMID: 28531553 DOI: 10.1016/j.jcv.2017.05.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/17/2017] [Accepted: 05/03/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND HIV RNA suppression is a key indicator for monitoring success of antiretroviral therapy. From a logistical perspective, viral load (VL) testing using Dried Blood Spots (DBS) is a promising alternative to plasma based VL testing in resource-limited settings. OBJECTIVES To evaluate the analytical and clinical performance of the Abbott RealTime HIV-1 assay using a fully automated one-spot DBS sample protocol. STUDY DESIGN Limit of detection (LOD), linearity, lower limit of quantitation (LLQ), upper limit of quantitation (ULQ), and precision were determined using serial dilutions of HIV-1 Virology Quality Assurance stock (VQA Rush University), or HIV-1-containing armored RNA, made in venous blood. To evaluate correlation, bias, and agreement, 497 HIV-1 positive adult clinical samples were collected from Ivory Coast, Uganda and South Africa. For each HIV-1 participant, DBS-fingerprick, DBS-venous and plasma sample results were compared. Correlation and bias values were obtained. The sensitivity and specificity were analyzed at a threshold of 1000 HIV-1 copies/mL generated using the standard plasma protocol. RESULTS The Abbott HIV-1 DBS protocol had an LOD of 839 copies/mL, a linear range from 500 to 1×107 copies/mL, an LLQ of 839 copies/mL, a ULQ of 1×107 copies/mL, and an inter-assay SD of ≤0.30 log copies/mL for all tested levels within this range. With clinical samples, the correlation coefficient (r value) was 0.896 between DBS-fingerprick and plasma and 0.901 between DBS-venous and plasma, and the bias was -0.07 log copies/mL between DBS-fingerprick and plasma and -0.02 log copies/mL between DBS-venous and plasma. The sensitivity of DBS-fingerprick and DBS-venous was 93%, while the specificity of both DBS methods was 95%. CONCLUSION The results demonstrated that the Abbott RealTime HIV-1 assay with DBS sample protocol is highly sensitive, specific and precise across a wide dynamic range and correlates well with plasma values. The Abbott RealTime HIV-1 assay with DBS sample protocol provides an alternative sample collection and transfer option in resource-limited settings and expands the utility of a viral load test to monitor HIV-1 ART treatment for infected patients.
Collapse
Affiliation(s)
- Ning Tang
- Abbott Molecular, 1300 East Touhy Avenue, Des Plaines, IL 60018-3315, USA.
| | | | - Andrea Frank
- Abbott Molecular, 1300 East Touhy Avenue, Des Plaines, IL 60018-3315, USA
| | - Zowie Bagley
- BARC-SA and Lancet Laboratories, Johannesburg, South Africa
| | - Raquel Viana
- BARC-SA and Lancet Laboratories, Johannesburg, South Africa
| | - John Lampinen
- Abbott Molecular, 1300 East Touhy Avenue, Des Plaines, IL 60018-3315, USA
| | - Gregor Leckie
- Abbott Molecular, 1300 East Touhy Avenue, Des Plaines, IL 60018-3315, USA
| | - Shihai Huang
- Abbott Molecular, 1300 East Touhy Avenue, Des Plaines, IL 60018-3315, USA
| | - Klara Abravaya
- Abbott Molecular, 1300 East Touhy Avenue, Des Plaines, IL 60018-3315, USA
| | | |
Collapse
|
7
|
Molecular Detection and Characterization of Human Immunodeficiency Virus Type 1. Mol Microbiol 2016. [DOI: 10.1128/9781555819071.ch30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
8
|
Allison KM, Faddy HM, Margaritis A, Ismay S, Marks DC. The impact on blood donor screening for human immunodeficiency virus, hepatitis C virus, and hepatitis B virus using plasma from frozen-thawed plasma preparation tubes. Transfusion 2015; 56:449-56. [PMID: 26456378 DOI: 10.1111/trf.13372] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/07/2015] [Accepted: 08/16/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Blood services are required to maintain repositories of frozen samples for confirmation of results and/or retrospective testing. The Australian Red Cross Blood Service archives donor samples in plasma preparation tubes (PPTs). This study aims to evaluate the effect of freeze-thawing and extended frozen storage on the ability to detect human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) using blood donation screening assays in samples stored in PPTs. STUDY DESIGN AND METHODS Whole blood was spiked with HIV-, HCV-, or HBV-reactive plasma at high and low viral loads and stored in PPTs or as plasma aliquots. All samples were frozen and stored at not more than -30°C. At 0, 3, 6, 12, 18, and 36 months, samples were tested for HIV and HCV antibodies, HBV surface antigen, and viral nucleic acid. Additional samples were thawed and refrozen either once or twice before testing to simulate up to three freeze-thaw cycles. RESULTS All PPT and plasma aliquots retained appropriate viral reactivity, including those with multiple freeze-thaw cycles, on both nucleic acid testing and serology platforms. CONCLUSION Frozen storage of biologicals in PPTs, as opposed to plasma aliquots, does not affect the ability to detect HIV, HCV, and HBV using viral nucleic acid or serology donation screening systems for up to 36 months. Freezing and thawing PPT samples did not impact the ability to detect these viruses. Our study demonstrates that PPTs appear to be an appropriate receptacle for frozen plasma sample archiving for up to 3 years.
Collapse
Affiliation(s)
- Kirsty M Allison
- Research and Development, Australian Red Cross Blood Service, Brisbane.,Manufacturing, Australian Red Cross Blood Service
| | - Helen M Faddy
- Research and Development, Australian Red Cross Blood Service, Brisbane.,School of Medicine, University of Queensland, Queensland, Australia
| | | | - Susan Ismay
- Manufacturing, Australian Red Cross Blood Service
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Brisbane
| |
Collapse
|
9
|
Hopkins M, Hau S, Tiernan C, Papadimitropoulos A, Chawla A, Beloukas A, Geretti AM. Comparative performance of the new Aptima HIV-1 Quant Dx assay with three commercial PCR-based HIV-1 RNA quantitation assays. J Clin Virol 2015. [PMID: 26209380 DOI: 10.1016/j.jcv.2015.05.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Quantitative measurement of HIV-1 RNA levels in plasma ('viral load') plays a central role in clinical management. The choice of assay platform can influence results and treatment decisions. OBJECTIVE To compare the analytical performance of the new TMA-based Hologic Aptima(®) HIV-1 Quant Dx assay with that of three PCR-based assays: Abbott RealTime HIV-1, Qiagen Artus(®) HI Virus-1 QS-RGQ, and Roche CAP/CTM HIV-1 Test v2. STUDY DESIGN Assay performance was evaluated using Acrometrix HIV-1 RNA Standard panels; the 3rd WHO HIV-1 RNA International Standard (12-500 copies/ml; 6 dilutions; 9 replicates); and plasma samples from 191 HIV-positive patients. RESULTS Aptima showed high (>0.99) precision, accuracy and concordance with the Acrometrix Standards across a wide dynamic range (2.0-6.7 log10copies/ml). Variance caused up to 2.1 (Aptima), 1.7 (RealTime), 7.5 (Artus), and 1.9 (CAP/CTM) fold changes in the International Standard quantifications at 50-500 copies/ml. HIV-1 RNA detection rates in plasma samples were 141/191 (74%), 119/191 (62%), 108/191 (57%), and 145/191 (76%) for Aptima, RealTime, Artus and CAP/CTM, respectively. For categorising samples either side of 50 copies/ml, Aptima had excellent agreement with RealTime (kappa 0.92; 95% CI 0.87-0.98); lowest agreement was with Artus (kappa 0.79; 95%CI 0.70-0.88). Aptima quantifications were mean 0.12 and 0.06 log10copies/ml higher compared with RealTime and CAP/CTM, respectively, and 0.05 log10copies/ml lower compared with Artus. Limits of agreement were narrowest when comparing Aptima to RealTime. CONCLUSIONS The new Aptima HIV assay is sensitive, precise, and accurate. HIV assays exhibit discordance at low HIV-1 RNA copy numbers.
Collapse
Affiliation(s)
- Mark Hopkins
- Liverpool Clinical Laboratories, Liverpool, United Kingdom.
| | - Sarah Hau
- Liverpool Clinical Laboratories, Liverpool, United Kingdom
| | | | | | - Anu Chawla
- Liverpool Clinical Laboratories, Liverpool, United Kingdom
| | | | | |
Collapse
|
10
|
Cloherty G, Swanson P, Lucic D, Dieckhaus K, Anthony P, Cataline P, Herman C, Hackett Jr J, Skolnik PR, Chirch L. Clinical implications of elevated HIV-1 viral load results obtained from samples stored frozen in vacutainer plasma preparation tubes. J Virol Methods 2014; 204:91-2. [DOI: 10.1016/j.jviromet.2014.01.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 01/18/2014] [Accepted: 01/24/2014] [Indexed: 10/25/2022]
|
11
|
Adachi D, Benedet M, Tang JW, Taylor GD. Comparative evaluation of Roche's COBAS Ampliprep/COBAS TaqMan HIV-1 Test v2.0 and Abbott's RealTime m2000sp/rt HIV-1 assay on PPTs and EDTA samples. J Clin Virol 2014; 60:78-9. [PMID: 24594081 DOI: 10.1016/j.jcv.2014.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 01/20/2014] [Accepted: 01/24/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Dena Adachi
- Alberta Provincial Laboratory for Public Health (Edmonton Site), Canada
| | - Marlin Benedet
- Alberta Provincial Laboratory for Public Health (Edmonton Site), Canada
| | - Julian W Tang
- Alberta Provincial Laboratory for Public Health (Edmonton Site), Canada.
| | | |
Collapse
|
12
|
Analytical variables influencing the HCV RNA determination by TaqMan real-time PCR in routine clinical laboratory practice. Mol Biol Rep 2012; 39:7421-7. [DOI: 10.1007/s11033-012-1574-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 01/28/2012] [Indexed: 10/25/2022]
|