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pubmed-article:11158091pubmed:abstractTextThe emergence of drug-resistant viral variants is the inevitable consequence of incomplete suppression of human immunodeficiency virus type 1 (HIV-1) replication during treatment with antiretroviral drugs. Sequencing to determine the resistance profiles of these variants has become increasingly important in the clinical management of HIV-1 patients, both in the initial design of a therapeutic plan and in selecting a salvage regimen. Here we have developed a pyrosequencing assay for the rapid characterization of resistance to HIV-1 protease inhibitors (PIs). Twelve pyrosequencing primers were designed and were evaluated on the MN strain and on viral DNA from peripheral blood mononuclear cells from eight untreated HIV-1-infected individuals. The method had a limit of detection of 20 to 25% for minor sequence variants. Pattern recognition (i.e., comparing actual sequence data with expected wild-type and mutant sequence patterns) simplified the identification of minor sequence variants. This real-time pyrosequencing method was applied in a longitudinal study monitoring the development of PI resistance in plasma samples obtained from four patients over a 2 1/2-year period. Pyrosequencing identified eight primary PI resistance mutations as well as several secondary mutations. This sequencing approach allows parallel analysis of 96 reactions in 1 h, facilitating the monitoring of drug resistance in eight patients simultaneously and, in combination with viral load analysis, should be a useful tool in the future to monitor HIV-1 during therapy.lld:pubmed
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pubmed-article:11158091pubmed:dateRevised2009-11-18lld:pubmed
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pubmed-article:11158091pubmed:articleTitleMonitoring resistance to human immunodeficiency virus type 1 protease inhibitors by pyrosequencing.lld:pubmed
pubmed-article:11158091pubmed:affiliationDepartment of Biotechnology, Royal Institute of Technology (KTH), S-100 44 Stockholm, Sweden.lld:pubmed
pubmed-article:11158091pubmed:publicationTypeJournal Articlelld:pubmed
pubmed-article:11158091pubmed:publicationTypeCase Reportslld:pubmed
pubmed-article:11158091pubmed:publicationTypeResearch Support, Non-U.S. Gov'tlld:pubmed
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