A genotypic assay for the amplification and sequencing of integrase from diverse HIV-1 group M subtypes

J Virol Methods. 2008 Nov;153(2):176-81. doi: 10.1016/j.jviromet.2008.07.008. Epub 2008 Sep 2.

Abstract

Recently, the Food and Drug Administration (FDA) of the USA approved the first integrase inhibitor for inclusion in treatment regimens of HIV-1 patients failing their current regimens with multi-drug resistant strains. However, treatment failure has been observed during integrase inhibitor-containing therapy. Several mutational pathways have been described with signature mutations at integrase positions 66, 92, 148 and 155. Therefore, a genotypic assay for the amplification and sequencing of HIV-1 integrase was developed. The assay displayed a detection limit of 10 HIV-1 III(B) RNA copies/ml plasma. As the HIV-1 pandemic is characterised by a large genetic diversity, the new assay was evaluated on a panel of 74 genetically divergent samples belonging to the following genetic forms A, B, C, D, F, G, J, CRF01-AE, CRF02-AG, CRFF03-AB, CRF12-BF and CRF13-cpx. Their viral load ranged from 178 until >500,000 RNA copies/ml. The amplification and sequencing was successful for 70 samples (a success rate of 95%). The four failures were most probably due to low viral load or poor quality of RNA and not to subtype issues. Some of the sequences obtained from integrase inhibitor-naïve patients displayed polymorphisms at integrase positions associated with resistance: 74IV, 138D, 151I, 157Q and 163AE. The relevance of these polymorphisms in the absence of the signature mutations remains unclear.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • DNA, Complementary
  • Drug Resistance, Viral / genetics*
  • Genotype
  • HIV Integrase / genetics*
  • HIV Integrase Inhibitors / pharmacology
  • HIV-1 / classification
  • HIV-1 / drug effects
  • HIV-1 / enzymology*
  • HIV-1 / genetics
  • Humans
  • Microbial Sensitivity Tests
  • Polymerase Chain Reaction / methods*
  • Pyrrolidinones / pharmacology
  • RNA, Viral / analysis
  • RNA, Viral / isolation & purification
  • Raltegravir Potassium
  • Sequence Analysis, DNA

Substances

  • DNA, Complementary
  • HIV Integrase Inhibitors
  • Pyrrolidinones
  • RNA, Viral
  • Raltegravir Potassium
  • HIV Integrase