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Antiretroviral genotypic resistance in plasma RNA and whole blood DNA in HIV-1 infected patients failing HAART
- Source :
- Journal of Medical Virology. 80:1695-1706
- Publication Year :
- 2008
- Publisher :
- Wiley, 2008.
-
Abstract
- The extent to which HIV-1 proviral DNA mutations cause clinically relevant antiretroviral resistance is still controversial. Paired plasma HIV-1 RNA and whole blood DNA were compared in patients failing HAART to investigate if the additional knowledge of archived mutations could improve the selection of potentially active drugs. Seventy-three HIV-1-infected patients with first/second HAART failure were studied before starting a new regimen based on RNA genotyping. Follow-up data after a 12-week therapy were available. DNA genotyping was retrospectively performed on stored whole blood samples and mutational profiles were compared to those from RNA. The mean number of IAS pol mutations was significantly higher in RNA (4.45 ± 2.76) than in DNA (2.88 ± 2.47) (P < 0.001). DNA genotyping provided a 6% increase in detection of resistance-associated mutations. Among 64/73 patients showing discordant DNA/RNA profiles, 54 (84%) also differed for predicted active drugs. 16/73 (22%) patients had ≥1 mutation revealed by DNA genotyping alone, probably affecting therapy success in 2/16. However, neither RNA/DNA discordance nor detection of isolated DNA mutations were statistically associated with outcome. In conclusion, plasma RNA remains the elective choice for HIV genotyping in patients with therapy failure, even if the detection of proviral resistance-associated mutations, not simultaneously found in RNA, is a frequent event. Therefore, in some cases DNA plus RNA genotyping might assist in choosing more accurately subsequent antiretroviral regimens. © 2008 Wiley-Liss, Inc.
- Subjects :
- Anti-HIV Agents
DNA Mutational Analysis
Molecular Sequence Data
Proviral DNA
HIV Infections
HAART failure
medicine.disease_cause
DNA Mutational Analysi
chemistry.chemical_compound
HIV Protease
Proviruses
Antiretroviral Therapy, Highly Active
Virology
Drug Resistance, Viral
medicine
Humans
Multicenter Studies as Topic
HIV Infection
Treatment Failure
Genotyping
Randomized Controlled Trials as Topic
COLD-PCR
Mutation
Plasma RNA
biology
Proviruse
Sequence Analysis, RNA
Anti-HIV Agent
RNA
Sequence Analysis, DNA
biology.organism_classification
HIV Reverse Transcriptase
Reverse transcriptase
Antiretroviral genotypic resistance
Infectious Diseases
chemistry
DNA, Viral
Lentivirus
Immunology
HIV-1
RNA, Viral
DNA
antiretroviral genotypic resistance
haart failure
hiv-1
plasma rna
proviral dna
Human
Subjects
Details
- ISSN :
- 10969071 and 01466615
- Volume :
- 80
- Database :
- OpenAIRE
- Journal :
- Journal of Medical Virology
- Accession number :
- edsair.doi.dedup.....0689657f4a598f8f3dc1705696479431