A Robust PCR Protocol for HIV Drug Resistance Testing on Low-Level Viremia Samples

Biomed Res Int. 2017:2017:4979252. doi: 10.1155/2017/4979252. Epub 2017 Apr 3.

Abstract

The prevalence of drug resistance (DR) mutations in people with HIV-1 infection, particularly those with low-level viremia (LLV), supports the need to improve the sensitivity of amplification methods for HIV DR genotyping in order to optimize antiretroviral regimen and facilitate HIV-1 DR surveillance and relevant research. Here we report on a fully validated PCR-based protocol that achieves consistent amplification of the protease (PR) and reverse transcriptase (RT) regions of HIV-1 pol gene across many HIV-1 subtypes from LLV plasma samples. HIV-spiked plasma samples from the External Quality Assurance Program Oversight Laboratory (EQAPOL), covering various HIV-1 subtypes, as well as clinical specimens were used to optimize and validate the protocol. Our results demonstrate that this protocol has a broad HIV-1 subtype coverage and viral load span with high sensitivity and reproducibility. Moreover, the protocol is robust even when plasma sample volumes are limited, the HIV viral load is unknown, and/or the HIV subtype is undetermined. Thus, the protocol is applicable for the initial amplification of the HIV-1 PR and RT genes required for subsequent genotypic DR assays.

MeSH terms

  • Drug Resistance, Viral / genetics
  • Genotype
  • HIV Infections / diagnosis
  • HIV Infections / genetics*
  • HIV Infections / virology
  • HIV-1 / genetics
  • HIV-1 / isolation & purification*
  • Humans
  • Mutation
  • Polymerase Chain Reaction
  • RNA, Viral / genetics
  • RNA, Viral / isolation & purification
  • Viral Load / genetics
  • Viremia / diagnosis
  • Viremia / genetics*
  • Viremia / virology
  • pol Gene Products, Human Immunodeficiency Virus / genetics*
  • pol Gene Products, Human Immunodeficiency Virus / isolation & purification

Substances

  • RNA, Viral
  • pol Gene Products, Human Immunodeficiency Virus