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Related Concept Videos

Viral Mutations00:36

Viral Mutations

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A mutation is a change in the sequence of bases of DNA or RNA in a genome. Some mutations occur during replication of the genome due to errors made by the polymerase enzymes that replicate DNA or RNA. Unlike DNA polymerase, RNA polymerase is prone to errors because it is not capable of “proofreading” its work. Viruses with RNA-based genomes, like HIV, therefore accrue mutations faster than viruses with DNA-based genomes. Because mutation and recombination provide the raw material...
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An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
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Practical updates in clinical antiviral resistance testing.

Hannah Wang1

  • 1Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA.

Journal of Clinical Microbiology
|July 25, 2024
PubMed
Summary

Antiviral resistance testing is evolving rapidly, shifting towards genotypic methods for common viruses like HIV and CMV. Clinical labs face challenges in interpreting results, especially with new sequencing technologies.

Keywords:
antiviral agentscytomegalovirusdrug resistance mechanismsherpes simplex virushuman immunodeficiency virus

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Area of Science:

  • Clinical Virology
  • Molecular Diagnostics
  • Infectious Diseases

Background:

  • Antiviral resistance testing is crucial for managing viral infections.
  • The field is dynamic due to new drugs, evolving viruses, and technological advancements.
  • Clinical laboratories face financial and logistical pressures impacting testing strategies.

Purpose of the Study:

  • To review the current landscape of antiviral resistance testing in the United States in 2024.
  • To cover common viruses including herpes simplex virus, cytomegalovirus, human immunodeficiency virus, influenza, hepatitis B, and hepatitis C.
  • To discuss test methods, resistance mechanisms, and clinical indications.

Main Methods:

  • Mini-review of clinically available antiviral resistance testing methods.
  • Focus on genotypic and phenotypic testing approaches.
  • Examination of next-generation sequencing technologies.

Main Results:

  • A shift from phenotypic to genotypic methods for initial clinical testing is evident.
  • Next-generation sequencing is becoming more prevalent in clinical laboratories.
  • Uncertainty exists regarding the clinical significance of detecting minority variants.

Conclusions:

  • Genotypic testing is increasingly the standard for antiviral resistance detection.
  • The interpretation of minority variants requires further clinical validation.
  • Adapting to technological and drug changes is essential for effective viral disease management.