Underestimation of HIV-1 Plasma Viral Burden in Patients Who Acquire Infection Abroad

In a suburban teaching hospital clinic, we diagnosed human immunodeficiency virus type 1 (HIV-1) infection in 10 patients who acquired the infection in Africa or Asia. All the patients had low viral plasma HIV RNA levels. This finding likely represents underestimation of true plasma viral burden in patients infected with non-B serotypes of HIV-1. Clinicians caring for immigrants with HIV infection need to be aware of the limitations of current commercial assays for the quantification of HIV-1 plasma viral burden, and better assays are needed for non-B HIV-1 serotypes.