HIV-1 genotyping for patients with viral load lower than 1,000 copies of RNA/mL

• Grant number: 11/23114-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2012
• End date: July 31, 2013
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Lenice Do Rosário de Souza
• Grantee: Larissa Ethel Soriano Freire
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

The choice for the best antiretroviral scheme for HIV-1 infection reduces viral replication in patients undergoing treatment and, consequently, decreases the chances for the emergence of viral mutation. It also prevents the selection of resistant mutants, which leads to successful treatment. The efficacy of the therapeutic scheme can be evaluated by the reduction in the HIV plasma viral load, and when it is lower than 50 copies of viral RNA per mL, it is usually not accompanied by the detection of mutations associated with resistance to antiretroviral drugs. The genotyping test is presently recommended for patients showing therapeutic failure, and it aims at evaluating the drugs that can be used in a new scheme. However, such a test is performed with the viral load limit of 1,000 copies of RNA/mL due to technical limitations. The proposals in this study are to validate genotyping for patients with a viral load lower than 1,000 copies of RNA/mL; validate the use of the provirus as source material for the genotyping test whenever plasma RNA is unavailable; to propose and validate a methodological alternative in face of the failure of the kit approach; to evaluate the number of mutations accumulated between the first and this typing as well as whether CD4+ count decreased and the clinical outcome in the period; to study the time elapsed between the first viral load above the detection limit and this genotyping.HIV-1-positive patients undergoing retroviral therapy, regardless of their gender and race, aged 18 years and older, assisted by the Specialized Outpatient Units Service and Day Hospital of the Botucatu School of Medicine - UNESP who underwent plasma viral load tests in 2010 and 211 will be included in the study. The patients will be divided into three groups: Group 1: 20 patients with a viral load above 5,000 copies of RNA/mL. Group 2: 20 patients with a viral load between 1,000 and 5,000 copies of RNA/mL. Group 3: 20 patients with a plasma viral load under 1,000 copies of RNA/mL.(AU)