Journal
JOURNAL OF CLINICAL MICROBIOLOGY
Volume 59, Issue 1, Pages -Publisher
AMER SOC MICROBIOLOGY
DOI: 10.1128/JCM.02303-20
Keywords
DBS; HIV-2; antiretroviral therapy; drug resistance; drug resistance testing; human immunodeficiency virus
Categories
Funding
- National Institutes of Health (NIH/NIAID) [2R01-AI060466, R01-AI120765]
- AIDS Clinical Trials Group [UM1-AI-068636, UM1-AI-106701]
- UW CFAR Retrovirology Core [P30-AI027757]
- U.S. National Institutes of Health
- University of Washington
- Bill & Melinda Gates Foundation
- Gilead Sciences
- Alere Technologies
- Merck Co.
- Janssen Pharmaceutica
- Cerus Corporation
- ViiV Healthcare
- Bristol-Myers Squibb
- Roche Molecular Systems
- Abbott Molecular Diagnostics
- Theratechnologies/TaiMed Biologics, Inc.
- ANRS
- Glaxo-Smith Kline
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The use of dried blood spots (DBS) for genotypic drug resistance testing for HIV-2 is feasible and can be deployed in resource-limited settings.
The treatment of HIV-2 in resource-limited settings (RLS) is complicated by the limited availability of HIV-2-active antiretroviral drugs and inadequate access to HIV-2 viral load and drug resistance testing. Dried blood spots (DBS)-based drug resistance testing, widely studied for HIV-1, has not been reported for HIV-2 and could present an opportunity to improve care for HIV-2-infected individuals. We selected 150 DBS specimens from ongoing studies of antiretroviral therapy (ART) for HIV-2 infection in Senegal and subjected them to genotypic drug resistance testing. Total nucleic acid was extracted from DBS, reverse transcribed, PCR amplified, and analyzed by population-based Sanger sequencing, and major drug resistance-associated mutations (RAM) were identified. Parallel samples from plasma and peripheral blood mononuclear cells (PBMC) were also genotyped. We obtained 58 protease/reverse transcriptase genotypes. Plasma viral load was significantly correlated with genotyping success (P< 0.001); DBS samples with corresponding plasma viral load >250 copies/ml had a success rate of 86.8%. In paired DBS-plasma genotypes, 83.8% of RAM found in plasma were also found in DBS, and replicate DBS genotyping revealed that a single test detected 86.7% of known RAM. These findings demonstrate that DBS-based genotypic drug resistance testing for HIV-2 is feasible and can be deployed in RLS with limited infrastructure.
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