HIV/HCV Genotyping and Resistance Testing
Dr. med. Hartmut Campe
Genotype resistance testing of HIV using Sanger technology is a standard accompaniment to therapy. Genetic information from reverse transcriptase, protease and integrase is examined for resistance-causing mutations and the efficacy of the relevant class of medication is checked using standard algorithms (Stanford, HIV-Grade…)
Ultra-deep sequencing can detect subpopulations of resistant viruses with greater sensitivity than the population based Sanger method. This information allows the specialist HIV physician to choose between standard recommendations on the basis of the population level and further individualized therapy taking into consideration the minority virus populations.
The same approach is currently being established for the resistance analyzes of new therapeutic agents (DAAs, direct acting agents) against chronic HCV infections. Target regions are NS3, NS4 and NS5. Furthermore, the accurate determination of the HCV genotype, which is possible with NGS, plays an important role in the choice of therapy.