1. HIV-1 tropism: a comparison between RNA and proviral DNA in routine clinical samples from Chilean patients.
- Author
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Ferrer P, Montecinos L, Tello M, Tordecilla R, Rodríguez C, Ferrés M, Pérez CM, Beltrán C, Guzmán MA, and Afani A
- Subjects
- Adolescent, Adult, Aged, Chile, Female, Genotype, HIV-1 genetics, HIV-1 isolation & purification, Humans, Male, Middle Aged, Young Adult, DNA, Viral genetics, Genotyping Techniques methods, HIV Infections virology, HIV-1 physiology, RNA, Viral genetics, Viral Tropism, Virology methods
- Abstract
Background: HIV in Chile has a notification rate of 0.01%. Coreceptor antagonists are a family of antiretroviral drugs that are used with the prior knowledge of patients HIV-1 tropism. Viral RNA-based tropism detection requires a plasma viral load ≥1000 copies/mL, while proviral DNA-based detection can be performed regardless of plasma viral load. This test is useful in patients with low or undetectable viral loads and would benefit with a proper therapy. The aim of this study was to determine the correlation between HIV RNA and proviral genotypic DNA tropism tests., Findings: Forty three Chilean patients were examined using population-based V3 sequencing, and a geno2pheno false-positive rate (FPR) cutoff values of 5, 5.75, 10 and 20%. With cutoff 5.75% a concordance of 88.4% in tropism prediction was found after a simultaneous comparison between HIV tropism assessment by RNA and DNA. In total, five discrepancies (11.6%) were found, 3 patients were RNA-R5/DNA-X4 and two were RNA-X4/DNA-R5. Proviral DNA enabled the prediction of tropism in patients with a low or undetectable viral load. For cutoff 5 and 5.75% genotypic testing using proviral DNA showed a similar sensitivity for X4 as RNA. We found that the highest sensitivity for detecting the X4 strain occurred with proviral DNA and cutoff of 10 and 20%. Viral loads were higher among X4 strain carriers than among R5 strain carriers (p < 0.05)., Conclusions: A high degree of concordance was found between tropism testing with RNA and testing with proviral DNA. Our results suggest that proviral DNA-based genotypic tropism testing is a useful option for patients with low or undetectable viral load who require a different therapy.
- Published
- 2013
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