A sensitive in-house RT-PCR genotyping system for combined detection of plasma HIV-1 and assessment of drug resistance

J Virol Methods. 2006 May;133(2):137-45. doi: 10.1016/j.jviromet.2005.11.004. Epub 2005 Dec 20.

Abstract

Quantification of the viral burden and identification of drug resistant mutations are important laboratory tools in the management of HIV-1 infected patients. However, widespread use of assays for viral load determination and genotyping is still hampered by the high cost. Here, an in-house RT-PCR-sequencing assay for HIV-1 drug resistance monitoring with the potential to be used both as a qualitative assay to detect the virus in plasma and as a genotyping system is described. A total of 377 clinical samples, collected from 374 HIV-infected patients of diverse geographic origin, were tested. The nested RT-PCR for amplification of the protease reverse transcriptase gene was found positive for 350 (92.8%) and 346 (91.8%) of 377 samples, respectively. All amplification-failures were due to viral loads of below 500 copies/ml. However, low viral load does not exclude amplification since 80.2 and 76% of 121 samples with viral loads of less than 500 copies/ml were amplified successfully for protease and reverse transcriptase, respectively. The high sensitivity of the assay was independent of the HIV-subtype, with a broad range of different HIV-1 subtypes tested. In conclusion the RT-PCR-direct sequencing method is convenient for the sensitive detection and subsequent genotyping of plasma RNA from a broad range of different HIV-1 subtypes. The assay enables the accurate follow-up of patients under treatment at a significantly reduced cost compared to the currently available commercial assays for viral load assessment and genotyping.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-HIV Agents / pharmacology
  • Base Sequence
  • Cohort Studies
  • Costs and Cost Analysis
  • Drug Resistance, Viral / genetics*
  • Female
  • Genes, Viral
  • Genotype
  • HIV Infections / blood
  • HIV Protease / genetics*
  • HIV Reverse Transcriptase / genetics*
  • HIV-1 / drug effects
  • HIV-1 / enzymology
  • HIV-1 / genetics*
  • HIV-1 / isolation & purification
  • Humans
  • Mutation
  • Nucleic Acid Amplification Techniques
  • Phylogeny
  • RNA, Viral / blood
  • Reverse Transcriptase Polymerase Chain Reaction / economics
  • Reverse Transcriptase Polymerase Chain Reaction / methods*
  • Sensitivity and Specificity
  • Viral Load

Substances

  • Anti-HIV Agents
  • RNA, Viral
  • HIV Reverse Transcriptase
  • HIV Protease