Phenotyping methods for determining HIV tropism and applications in clinical settings

作者：Raymond Stephanie; Delobel Pierre; Izopet Jacques^*

来源：Current Opinion in HIV and AIDS, 2012, 7(5): 463-469.

DOI：10.1097/COH.0b013e328356f6d7

• CCR5
• coreceptor
• CXCR4
• HIV tropism
• phenotypic assay

Purpose of review %26lt;br%26gt;HIV-1 enters CD4-expressing cells via one or both of the chemokine receptors CCR5 and CXCR4. Specific CCR5 antagonists are now in clinical use, but only for CCR5-tropic viruses. Hence, several methods have been developed for assessing HIV-1 tropism in patients who are candidates for CCR5 antagonists. This article reviews current data on phenotypic assays of tropism. %26lt;br%26gt;Recent findings %26lt;br%26gt;Phenotypic assays are still used as reference, although genotypic methods have improved. The main advantages of phenotypic assays are their great sensitivity for detecting minor CXCR4-using variants and their capacity to assess non-B subtypes of HIV-1. Clinical trials of maraviroc have, thus, relied on the phenotypic determination of HIV-1 tropism. However, new genotypic approaches that are more sensitive for minor CXCR4-using variants, notably ultra-deep pyrosequencing, are now challenging phenotypic assays. Nevertheless, phenotypic assays are essential for improving genotypic algorithms for determining HIV-1 tropism as well as for assessing the resistance of R5-tropic viruses to CCR5 antagonists. %26lt;br%26gt;Summary %26lt;br%26gt;HIV-1 tropism should be determined before using CCR5 antagonists. Phenotypic recombinant assays are still the benchmark tests for characterizing HIV-1 tropism as their great sensitivity enables them to detect minor CXCR4-using variants of both B and non-B HIV-1 subtypes.

• 出版日期2012-9