Performance of plasma separation cards for HIV drug-resistance genotyping in a resource-limited setting: comparison with plasma samples
Abstract
Background HIV drug resistance (HIVDR) threatens the effectiveness of antiretroviral therapy (ART) programmes in low- and middle-income countries. The Cobas Plasma Separation Card (PSC) is a recently developed specimen collection tool with potential to expand access to HIVDR genotyping in remote settings. This study evaluates PSC performance for HIVDR genotyping compared with plasma. Methods Paired plasma and PSC specimens were selected from 250 people living with HIV (PLHIV) on ART ≥6 months with viral load (VL) ≥1000 copies/mL. HIVDR genotyping followed CDC Atlanta in-house protocol; resistance interpretation used the Stanford HIVdb algorithm. Paired sequences were compared for subtype, nucleotide similarity, mutation profile and drug-resistance classification. Results Twenty paired specimens met inclusion criteria. Amplification of the HIV-1 Pol gene succeeded in 19/20 (95%) PSC samples. Of 19 paired sequences, nucleotide similarity was 98.5% (IQR 98.0%–99.3%). Eleven plasma samples showed 37 major drug-resistance mutations (MDM); 35 (94.6%) concordant MDM were identified in PSC. Discordances in four pairs were limited to mixed versus single bases and did not alter drug-resistance classification. Only one pair showed a clinically significant discordance (K103N detected in plasma but not initially in PSC). Conclusions PSC demonstrated good concordance with plasma for HIVDR genotyping and has potential as an alternative specimen type for clinical practice and surveillance in resource-limited settings.
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BibTeX
@article{pham2026performance,
title = {{Performance of plasma separation cards for HIV drug-resistance genotyping in a resource-limited setting: comparison with plasma samples}},
author = {Thang Hong Pham and Hanh Thi Hong Ngo and Tram Thi Phuong Pham and Nhung Thi Hong Le and Mai Thi Nguyen and Tuan Anh Nguyen and Huyen Thi Do and Duong Nhu Tran and Lan Trong Phan and Yoann Madec},
journal = {Journal of Antimicrobial Chemotherapy},
year = {2026},
month = sep,
doi = {10.1093/jac/dkag279},
url = {https://pasteur.hal.science/pasteur-05732193v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Performance of plasma separation cards for HIV drug-resistance genotyping in a resource-limited setting: comparison with plasma samples
AU - Thang Hong Pham
AU - Hanh Thi Hong Ngo
AU - Tram Thi Phuong Pham
AU - Nhung Thi Hong Le
AU - Mai Thi Nguyen
AU - Tuan Anh Nguyen
AU - Huyen Thi Do
AU - Duong Nhu Tran
AU - Lan Trong Phan
AU - Yoann Madec
PY - 2026
DA - 2026/09/04
JO - Journal of Antimicrobial Chemotherapy
DO - 10.1093/jac/dkag279
UR - https://pasteur.hal.science/pasteur-05732193v1
AB - Background HIV drug resistance (HIVDR) threatens the effectiveness of antiretroviral therapy (ART) programmes in low- and middle-income countries. The Cobas Plasma Separation Card (PSC) is a recently developed specimen collection tool with potential to expand access to HIVDR genotyping in remote settings. This study evaluates PSC performance for HIVDR genotyping compared with plasma. Methods Paired plasma and PSC specimens were selected from 250 people living with HIV (PLHIV) on ART ≥6 months with viral load (VL) ≥1000 copies/mL. HIVDR genotyping followed CDC Atlanta in-house protocol; resistance interpretation used the Stanford HIVdb algorithm. Paired sequences were compared for subtype, nucleotide similarity, mutation profile and drug-resistance classification. Results Twenty paired specimens met inclusion criteria. Amplification of the HIV-1 Pol gene succeeded in 19/20 (95%) PSC samples. Of 19 paired sequences, nucleotide similarity was 98.5% (IQR 98.0%–99.3%). Eleven plasma samples showed 37 major drug-resistance mutations (MDM); 35 (94.6%) concordant MDM were identified in PSC. Discordances in four pairs were limited to mixed versus single bases and did not alter drug-resistance classification. Only one pair showed a clinically significant discordance (K103N detected in plasma but not initially in PSC). Conclusions PSC demonstrated good concordance with plasma for HIVDR genotyping and has potential as an alternative specimen type for clinical practice and surveillance in resource-limited settings.
SN - 0305-7453
SN - 1460-2091
ER -