Human immunodeficiency virus (HIV) affects millions of people around the world, particularly in low- and middle-income countries. Left untreated, it causes acquired immunodeficiency syndrome (AIDS), which destroys the person’s immune system, leaving them vulnerable to deadly opportunistic infections. HIV’s unusual biology makes it difficult for the human body to fight on its own and has prevented the development of a vaccine since the virus’s discovery in the 1980s, making antiretroviral drugs the standard treatment. Unfortunately, the virus also evolves drug resistance (DR) relatively quickly, even within a single patient. The challenges this retrovirus presents are insurmountable without usable tests for drug resistance.
In this webinar*, Dr. Joy Chang of the United States Centers for Disease Control (CDC) discusses the CDC’s experience investigating the Applied BiosystemsTM HIV-1 Genotyping Kit with Integrase*. Their study objective was to determine whether this test meets the requirements for enhanced HIV-1 resistance monitoring, specifically of the integrase region of the pol gene. Dr. Joy Chang of the CDC reports that this assay’s integration of integrase primers enables it to detect all known subtypes of HIV with an accuracy of over 99.5%, with some going as high as 99.8%. In her words, “This partially multiplexed HIV drug resistance assay meets all WHO HIVDR assay performance criteria for surveillance. It uses a minimum amount of sample, is sensitive, and has potential to be a low-cost assay to monitor DR mutations in PRRT [reverse transcriptase] and INT [integrase] regions.”
Having such an accurate and sensitive test for HIV-1 genetic variants that resist common antiretroviral therapeutics is critical for epidemiologic and genetic surveillance studies. Administered broadly, discerning tests and subsequent sequencing of new variants provides a population-level picture of the strains circulating in an area and early warning of their migration to new areas. This information can guide national antiretroviral strategies, alerting governments to when they should start making new antiretrovirals available before a new variant causes a surge in drug-resistant cases or a shortage compromises treatment for infected persons.
The integrase enzyme is an important part of both the retrovirus’s replication and the evolution of its drug resistance. Integrase helps HIV integrate its genome into that of its host and is critical to the viral reproduction cycle. Because of this, antiretroviral medications often target integrase to suppress replication, and drug-resistance mutations can affect HIV integrase. However, integrase has not been consistently monitored as part of HIV surveillance. The World Health Organization (WHO) has identified need for a user-friendly, sensitive, and low-cost HIV drug resistance assay sufficient to monitor mutations in the protease, reverse-transcriptase, and integrase regions of the pol gene, particularly in hard-hit countries and regions such as sub-Saharan Africa. Dr. Chang’s findings indicate that the Applied BiosystemsTM HIV-1 Genotyping Kit with Integrase can function in this role.
For more information about the Applied BiosystemsTM HIV-1 Genotyping Kit w/ Integrase, click here.
*This webinar is dedicated to the public domain
*For research use only. Not for use in diagnostic procedures