期刊
JOURNAL OF CLINICAL MICROBIOLOGY
卷 49, 期 12, 页码 4077-4082出版社
AMER SOC MICROBIOLOGY
DOI: 10.1128/JCM.01004-11
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资金
- National Institutes of Health (NIH) [R01-HD057784-04, R01-AI38576, U01-AI068632, BRS-IMPCT-Q-00100-T014, BRS-IMPCT-Q-06-00100-T003]
- Elizabeth Glaser Pediatric AIDS Foundation
- National Institute of Allergy and Infectious Diseases (NIAID) [U01 AI068632]
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
- National Institute of Mental Health (NIMH) [AI068632]
- Statistical and Data Analysis Center at Harvard School of Public Health under the NIAID [5 U01 AI41110]
- NIAID
- NICHD International and Domestic Pediatric and Maternal HIV Clinical Trials Network
- NICHD [N01-DK-9-001/HHSN267200800001C]
Monitoring HIV drug resistance is an important component of the World Health Organization's global HIV program. HIV drug resistance testing is optimal with commercially available clinically validated test kits using plasma; however, that type of testing may not be feasible or affordable in resource-constrained settings. HIV genotyping from dried blood spots (DBS) with noncommercial (in-house) assays may facilitate the capture of HIV drug resistance outcomes in resource-constrained settings but has had varying rates of success. With in-house assays for HIV reverse transcriptase, we evaluated the yield of genotyping DBS samples collected from HIV-infected children who were enrolled in two clinical trials conducted in sub-Saharan Africa (median HIV viral load, 5.88 log(10) HIV RNA copies/ml; range, 4.04 to 6.99). Overall, HIV genotypes were obtained for 94 (89.5%) of 105 samples tested (95% and 84% from clinical trials #1 and #2, respectively); however, successful analysis of 15 (16.1%) of the 94 samples required repeat testing using a different set of primers on previously synthesized cDNA. The yield of genotyping was lower on the DBS that were stored suboptimally from clinical trial #2 (56% versus 88% for optimally stored). Concordance with plasma genotypes derived using a clinically validated, commercial kit-based assay (ViroSeq HIV-1 genotyping system) was also assessed in a subset of children with paired testing. For 34 samples with paired DBS and plasma genotypes, there was 100% concordance for major drug resistance mutations. DBS genotyping using in-house assays provides an alternative for antiretroviral drug resistance testing in children in resource-constrained regions but may require regionspecific optimization before widespread use.
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