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Genotypic Inference of HIV-1 Tropism Using Population-based Sequencing of V3
Published on: December 27, 2010
[Methods for determining viral tropism: genotype and phenotype tests].
Mayte Perez-Olmeda1, Eva Poveda
1Unidad de Inmunopatologia del Sida, Instituto de Salud Carlos III, Madrid, España. mayteperez@isciii.es
Enfermedades Infecciosas Y Microbiologia Clinica
|January 10, 2009
Summary
The first CCR5 antagonist, Maraviroc, requires viral tropism testing. Phenotyping assays, like Trofile, are most reliable for determining R5 or X4 tropism to guide treatment decisions.
Area of Science:
- Virology
- Pharmacology
- Infectious Diseases
Context:
- The introduction of Maraviroc (MVC), a CCR5 antagonist, necessitates accurate viral tropism determination for patient selection.
- Understanding viral tropism is crucial for predicting treatment response to MVC, which targets R5-tropic variants.
Purpose:
- To review current methods for determining viral tropism, focusing on phenotyping assays.
- To highlight the challenges in detecting minority X4-tropic variants that can lead to virological failure with MVC.
- To evaluate the correlation between genotyping and phenotyping methods for therapeutic decision-making.
Summary:
- Phenotyping assays, particularly the clinically validated Trofile assay, are considered the gold standard for determining viral tropism.
- Genotyping methods offer speed and simplicity but require optimization for sensitivity in detecting minority X4-tropic variants.
- The presence of X4-tropic variants is linked to virological failure, emphasizing the need for sensitive detection tools.
Impact:
- Informs clinical practice regarding the selection of patients for Maraviroc therapy based on viral tropism.
- Drives further research into improving the sensitivity and accuracy of tropism testing methods.
- Contributes to optimizing treatment strategies for HIV infection by refining the use of CCR5 antagonists.
