Technologies for HIV-1 drug resistance testing: inventory and needs

Area of Science:

• Virology
• Genomics
• Molecular Diagnostics

Background:

• HIV-1 drug resistance (HIV DR) testing is crucial for effective antiretroviral therapy.
• Sanger population sequencing is the current standard for HIV DR testing.
• Next-generation sequencing (NGS) technologies are emerging as powerful alternatives.

Purpose of the Study:

• To review the current applications and challenges of NGS in HIV DR testing.
• To highlight the advantages of NGS over Sanger sequencing.
• To discuss the future directions for NGS implementation in HIV DR diagnostics.

Main Methods:

• Comparative analysis of NGS and Sanger sequencing for HIV DR testing.
• Review of existing NGS protocols and their performance.
• Identification of challenges and areas for improvement in NGS implementation.

Main Results:

• NGS methods are noninferior to Sanger sequencing for consensus sequence derivation.
• NGS enables high-throughput sequencing of near full-length HIV-1 genomes.
• NGS can detect low-abundance drug-resistant HIV-1 variants, though clinical significance requires further study.

Conclusions:

• NGS offers significant advantages for HIV DR testing, including enhanced genomic insights.
• Addressing challenges in quality management and standardization is essential for widespread NGS adoption.
• NGS has the potential to revolutionize personalized antiretroviral treatment strategies.