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« Setting up a platform for capillary sequencing at the Fort-de-France University Hospital »

« Setting up a platform for capillary sequencing at the Fort-de-France University Hospital »

 

This project is run by the University Hospital of Fort-de-France


Thanks to the INTERREG IV-HIV Project, the virology laboratory of the University Hospital of Martinique has acquired a last generation capillary sequencer and chain reaction apparatus. The, hereby constituted, platform has provided access to the study of resistance to all antiretroviral treatments including the most recent ones (protease, reverse transcriptase, and integrase inhibitors) and the tropism of HIV strains. These resistance tests are made ​​from plasma from patients or drops of blood placed on a blotting type paper (DBS, dry blood spot). DBS have the advantage over plasma to be non-infectious samples that can be stored at room temperature. This allows the analysis of samples from sites of patient care that do not have the necessary settings to perform and/or preserve the plasma samples without any break in the cold chain to the laboratory. Furthermore DBS are transmitted at room temperature as a letter, which simplifies air shipping while reducing transportation costs.

Since the installation of the capillary sequencer, resistance tests were performed on samples from different Caribbean countries (Antigua, St Kitts and Haiti). The obstacle of breaking the cold chain during air transportation has been lifted thanks to DBS, as we stressed out when conducting a consecutive series of 30 resistance tests on DBS from Port au Prince, Haiti. All the resistance tests results were sent to prescribing physicians with an interpretation in therapeutic terms. A new round of resistance tests on DBS from Haiti is scheduled for the last quarter of 2014.

The virology laboratory of the University Hospital of Martinique is the WHO regional reference laboratory for resistance tests. In this capacity, it participates in the development and standardization of the use of DBS by the WHO. In 2013, the Virology Laboratory of the University Hospital of Martinique participated in the WHO world quality control tests resistance from DBS. The techniques developed on the capillary sequencer allowed it to be one of the 7 laboratories to have passed this quality control. The final accreditation report for testing from DBS, by the WHO, is being finalized.


Under the INTERREG IV-HIV Project, the virology laboratory of the University Hospital of Martinique participated in collaboration with the WHO and the National Public Health Laboratory of Haiti in Port au Prince in a study on resistances observed on 130 patients before the beginning of the treatment and one year later. Besides participating in the development of the protocol, the virology service conducted resistance tests (160) and viral loads (101). The results of this study were presented at the International Workshop of Antiviral Resistance 'in Berlin, Germany in June 2014 (see below) and will be published after finalization.

At the "workshop on the Methodology for the monitoring of HIV Drug Resistance in the Caribbean" held on June 16 to 18, 2014 in Port of Spain, Trinidad, representatives of the OECS countries have determined that new WHO protocols for resistance monitoring before and during treatment were achievable within the member countries of the OECS as a multinational surveillance. It was decided that the study would be conducted in collaboration between the Ministries of Health of the countries involved, the Public Health Agency of Canada and the virology laboratory of the University Hospital of Martinique which will perform the laboratory tests (250-300 tests resistance and viral loads). This study is expected to begin in 2015 and continue in 2016.

Finally, we must point out that the implementation of the sequencing platform will also soon allow the genotyping of hepatitis C, already done by a commercial method which will be abandoned in late 2014 by its manufacturer.

Project Manager :M. Georges DOS SANTOS, PhD

Laboratoire de virologie CHU Martinique

Laboratoire Régional de Référence OMS Génotypage VIH

 BP 632

97200 Fort-de-France Cedex

Tel : 00 596 596 552 433, This email address is being protected from spambots. You need JavaScript enabled to view it.