Primary HIV-1 Drug Resistant Minority Variants.
Primary HIV drug resistant mutations are mutations that occur in an HIV-infected individual prior to the initiation of antiretroviral therapy (ART). These mutations may arise by de novo mutagenesis or result from transmission. Drug resistant mutations (DRMs) may reduce the effectiveness of ART leading to inadequate virological outcomes. Currently, Sanger sequencing is the standard method for detection of DRMs to inform treatment decisions, but does not detect minor variant mutations. Drug resistant minority variants (DRMVs) can be detected by next generation sequencing (NGS). However, several challenges including cost of infrastructure and the need for complex data analysis bioinformatics tools remain major setbacks for NGS use. More importantly, the clinical impact of DRMVs on ART is not well understood, underscoring the importance for understanding whether the levels of primary DRMVs for different mutations impact on the effectiveness of ART and the rationale for inclusion in routine diagnostics. Understanding the impact of primary DRMVs will help inform how NGS may be utilized in the future for pre-emptive clinical ART decision making.
Africa Centre for Population Health, Doris Duke Medical Research Institute, Nelson Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.|Department of Virology, National Health Laboratory Service, University of KwaZulu-Natal, Durban, South Africa.|Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa.
Benjamin
B
Chimukangara
Department of Virology, National Health Laboratory Service, University of KwaZulu-Natal, Durban, South Africa.
Reshmi
R
Samuel
Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa.|South African Medical Research Council (SAMRC) - CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Durban, South Africa.
Kogieleum
K
Naidoo
Africa Centre for Population Health, Doris Duke Medical Research Institute, Nelson Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Tulio
T
de Oliveira
D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D009154:Mutation
D019380:Anti-HIV Agents