Re M C, Monari P, Bon I, Gibellini D, Vitone F, Borderi M, La Placa M
Department of Clinical and Experimental Medicine, Section of Microbiology, University of Bologna, Via Massarenti, 940138 Bologna, Italy.
BMC Microbiol. 2001;1:30. doi: 10.1186/1471-2180-1-30. Epub 2001 Nov 27.
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.
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.
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.
对新感染HIV-1的个体进行耐药性常规检测表明，耐药变异株的传播可能会增加。采用线性探针法（LIPA）和TruGene HIV-1检测法对27例未接受过治疗的意大利HIV-1感染患者的血浆样本进行分析，以检测赋予HIV-1耐药性的突变。
两种检测方法均在不同数量的患者中发现了与耐药性相关的氨基酸替代。特别是，分别通过LIPA和测序分析检测到的两个突变（K70R和V118I）显示，两个血浆样本对核苷类逆转录酶抑制剂（NRTIs）耐药。病毒序列分析发现至少三个对非核苷类逆转录酶抑制剂（NNRTIs）耐药的突变，这些突变用商业LIPA检测不到，且仅与核苷类逆转录酶类似物相关。此外，大多数样本显示出与蛋白酶抑制剂耐药相关的突变。值得注意的是，只有LIPA检测到一个关键突变，如V82A（以混合物形式发现）和一些“不确定”结果（9个样本），这是由于对应特定探针的条带上没有信号，而不同数量的次要突变只能通过TruGene HIV-1检测法检测到。
尽管需要进一步研究以确定不同检测方法对耐药菌株传播评估的影响，但LIPA可能适用于需要在短时间内获得大量结果的广泛人群分析，而测序分析虽然更昂贵且技术更复杂，但能够检测到对NRTIs和NNRTIs均耐药的突变，可能被认为是一种更全面的检测方法。
