Tropism testing in the clinical management of HIV-1 infection.
Tropism testing in the clinical management of HIV-1 infection.
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DOI：
10.1097/coh.0b013e328331b929
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发表时间：
2009-11
影响因子：
4.1
通讯作者：
Kuritzkes DR
中科院分区：
文献类型：
--
作者：
Lin NH;Kuritzkes DR
有多种方法可用于确定HIV-1共受体的使用，通常被称为病毒趋向性。本文综述了HIV-1嗜性的表型和基因分析的最新数据。趋向性分析用于确定可能接受CCR5拮抗剂治疗的患者中HIV-1的共同受体使用情况。表型分析最常用于CCR5拮抗剂的临床试验，并被认为是与其他趋向性测试方法进行比较的“金标准”。通过改进，可以检测到较低阈值的使用CXCR4的次要物种。与表型分析相比，基因分型方法在检测使用HIV-1的CXCR4时敏感性较差，但特异性较好。最近的一项比较研究的初步结果表明，在预测对CCR5拮抗剂的病毒学反应方面，一些基因分型方法可能与表型试验一样有效。几项研究表明，趋向性测试可能提供有关疾病进展风险的有用预后信息。了解不同趋向性分析方法的特点，对其临床应用具有重要意义。尽管表型检测目前受到青睐，但在适当的环境下，基因分型检测可能是一种合适的替代方法。
A variety of methods are available to determine HIV-1 co-receptor usage, commonly referred to as viral tropism. This article reviews recent data on phenotypic and genotypic assays of HIV-1 tropism. Tropism assays are used to determine co-receptor usage of HIV-1 in patients who may be candidates for treatment with CCR5 antagonists. Phenotypic assays are used most often in the clinical trials of CCR5 antagonists, and are considered the “gold standard” for comparison to other methods of tropism testing. Enhancements have allowed detection of a lower threshold of minor CXCR4-using species. When compared to phenotypic assays, genotypic methods have poor sensitivity but good specificity at detecting CXCR4-using HIV-1. Preliminary results from a recent comparative study suggest that some genotypic methods may perform as well as phenotypic tests in predicting virologic response to CCR5 antagonists. Several studies show that tropism testing may provide useful prognostic information regarding the risk of disease progression. Understanding the characteristic of different tropism assays is important for their clinical use. Although phenotypic testing currently is favored, genotypic assays may be a suitable alternative in appropriate settings.