สถาบันวิจัยวิทยาศาสตร์สาธารณสุข

National Institute of Health of Thailand

An Efficient Tool for Surveying CRF01_AE HIV Type 1 Resistance in Thailand to Combined Stavudine-Lamivudine-Nevirapine Treatment: Mutagenically Separated PCR Targeting M184I/V.

Authors : Saeng-Aroon S, Yoshida LM, Ariyoshi K, Taguchi M, Pathipvanich P, Rojanawiwat A, Matsuda M, Kannagi M, Sawanpanyalert P, Sugiura W, Auwanit W.


 

Affiliations : 

National lnstitute of Health, Department of Medical Sciences, Ministry of Public Health,
Nonthaburi, Thailand
          

Source : AIDS Res Hum Retroviruses. 2007 Dec; 23(12):1461-8.
Language : English
 

Abstract :

 
 

        Under programs organized by the government of Thailand, HIV-1-infected patients have been treated since 2002 with several regimens, including a tablet known as GPOvir, which contains lamivudine, stavudine, and nevirapine. The aim of this study was to establish an effective assay, based on mutagenically separated PCR (MS-PCR), with the goal of surveying GPOvir-resistant HIV-1 cases. To determine the target mutation point for the assay, we analyzed the patterns of acquired drug resistance in plasma samples from  GPOvir-failed cases. Of 428 HIV-1-infected individuals treated with GPOvir at Lampang Hospital in northern Thailand from 2002 to 2004, 66 had detectable viral loads after 3 months of treatment. The HIV-1 sequences of these 66 GPOvir-failed cases and 55 pre-GPOvir baseline samples were analyzed. The most prevalent drug resistance mutation among the samples was the lamivudine resistance M184I/V mutation. Based on this finding,we developed a new MS-PCR assay to detect the M184I/V mutation, and evaluated the assay performance for detecting GPOvir-resistant CRF01_AE cases. Comparing the results of M184I/V MS-PCR and sequence analyses, we found a concordance rate of 95% and an overall sensitivity of the M184I/V MS-PCR for detecting GPOvir-resistant cases of 79%. Considering the relatively low price of the assay, approximately $12.50 per sample, M184I/V MS-PCR may be a candidate for monitoring a large number of GPOvir-treated patients, particularly in developing nations.