title: Analysis of HIV-1 drug resistant mutations by line probe assay and direct sequencing in a cohort of therapy naive HIV-1 infected Italian patients.
abstract: BACKGROUND
  The routine determination of drug resistance in newly HIV-1 infected individuals documents a potential increase in the transmission of drug-resistant variants. Plasma samples from twenty seven therapy naive HIV-1 infected Italian patients were analyzed by the line probe assay (LIPA) and the TruGene HIV-1 assay for the detection of mutations conferring resistance to HIV-1.
  
  
  RESULTS
  Both tests disclosed amino-acid substitutions associated with resistance in a variable number of patients. In particular, two mutations (K70R and V118I), detectable by LIPA and by sequencing analysis respectively, revealed resistance to NRTIs in two plasma samples. At least three mutations conferring resistance to NNRTIs, not detectable by commercial LIPA, able to reveal mutations associated only with nucleoside reverse transcriptase analogues, were disclosed by viral sequence analysis. Moreover, most samples showed mutations correlated with resistance to protease inhibitors. Remarkably, a key mutation, like V82A (found as a mixture), and some "indeterminate" results (9 samples), due the absence of signal on the lines corresponding to a specific probe, was revealed only by LIPA, while a variable number of secondary mutations was detectable only by TruGene HIV-1 assay.
  
  
  CONCLUSIONS
  Even if further studies are necessary to establish the impact of different tests on the evaluation of drug-resistant strains transmission, LIPA might be useful in a wide population analysis, where bulk results are needed in a short time, while sequencing analysis, able to detect mutations conferring resistance to both NRTIs and NNRTIs, might be considered a more complete assay, albeit more expensive and more technically complex.
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Microbiology, University of Bologna, Via Massarenti, 940138 Bologna, Italy. remc@med.unibo.it
authors.forename: M C
authors.initials: MC
authors.lastname: Re
authors.forename: P
authors.initials: P
authors.lastname: Monari
authors.forename: I
authors.initials: I
authors.lastname: Bon
authors.forename: D
authors.initials: D
authors.lastname: Gibellini
authors.forename: F
authors.initials: F
authors.lastname: Vitone
authors.forename: M
authors.initials: M
authors.lastname: Borderi
authors.forename: M
authors.initials: M
authors.lastname: La Placa
mesh_terms: D019943:Amino Acid Substitution; D015331:Cohort Studies; D024882:Drug Resistance, Viral / Q000235:genetics*; D015658:HIV Infections / Q000821:virology; D017320:HIV Protease Inhibitors / Q000494:pharmacology; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics* / Q000502:physiology; D007558:Italy; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology; D019562:Viral Load
chemical_list: D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors