Application of HIV - 1 genotypic resistance testing in clinical treatment and follow - up

Objective To explore the feasibility of HIV - 1 genotypic resistance testing and its potential clinical application in HIV- infected patients receiving highly active antiretroviral therapy(HAART) . Methods HIV- 1 viral RNA was extracted from plasma samples of HIV - infected patients receiving HAART and amplified by nested RT - PCR using specific primers. Nucleotide sequences of HIV- 1 protease (PR) and reverse transcriptase(RT) genes were determined by automated DNA sequencer and analyzed using specific biological software. Results RT - PCR products were obtained from the plasma samples of patients whose viral load was as low as 1000 copies/ml.Specific drug- resistant mutations were detected in the PR and RT genes of one (DP31) out of 16 HIV - infected individuals, which were L63P, T215F, K219Q and M184V mutations. In addition, T215F and K219Q mutations were emerged in DP31 before the initiation of HAART, indicuating these drug - resistant viruses might have been transmitted during the initial acquisition of HIV infection.Conclusion HIV- 1 genotypic resistance testing can be used effectively to detect drug resistant viruses in plasma of patient on HAART. The results of genotyping may provide physicians with information for choosing the appropriate antiretroviral drugs and optimizing regimens