Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich.
Institute of Medical Virology, University of Zurich, Zurich, Switzerland.
Curr Opin HIV AIDS. 2022 Jul 1;17(4):222-228. doi: 10.1097/COH.0000000000000737.
HIV-1 drug resistance (HIV DR) testing is routinely performed by genotyping plasma viruses using Sanger population sequencing. Next-generation sequencing (NGS) is increasingly replacing standardized Sanger sequencing. This opens up new opportunities, but also brings challenges.
The number of NGS applications and protocols for HIV DR testing is increasing. All of them are noninferior to Sanger sequencing when comparing NGS-derived consensus sequences to Sanger sequencing-derived sequences. In addition, NGS enables high-throughput sequencing of near full-length HIV-1 genomes and detection of low-abundance drug-resistant HIV-1 variants, although their clinical implications need further investigation. Several groups have defined remaining challenges in implementing NGS protocols for HIV-1 resistance testing. Some of them are already being addressed. One of the most important needs is quality management and consequently, if possible, standardization.
The use of NGS technologies on HIV DR testing will allow unprecedented insights into genomic structures of virus populations that may be of immediate relevance to both clinical and research areas such as personalized antiretroviral treatment. Efforts continue to tackle the remaining challenges in NGS-based HIV DR testing.
HIV-1 耐药性（HIV DR）检测通常通过使用 Sanger 群体测序对血浆病毒进行基因分型来进行。下一代测序（NGS）越来越多地取代标准化的 Sanger 测序。这既带来了新的机遇，也带来了挑战。
用于 HIV DR 检测的 NGS 应用和方案的数量正在增加。在将 NGS 衍生的共识序列与 Sanger 测序衍生的序列进行比较时，所有这些方法在比较 NGS 衍生的共识序列与 Sanger 测序衍生的序列时均不逊于 Sanger 测序。此外，NGS 能够高通量测序近乎全长的 HIV-1 基因组，并检测低丰度耐药性 HIV-1 变异体，尽管其临床意义仍需进一步研究。有几个小组已经定义了在实施 HIV-1 耐药性 NGS 检测协议方面存在的剩余挑战。其中一些已经在解决。最重要的需求之一是质量管理，因此，如果可能的话，还需要标准化。
在 HIV DR 检测中使用 NGS 技术将允许对病毒群体的基因组结构进行前所未有的深入了解，这可能对临床和研究领域（如个体化抗逆转录病毒治疗）具有直接意义。人们仍在努力解决基于 NGS 的 HIV DR 检测中存在的剩余挑战。
