Name: genotypic inference of hiv-1 tropism using population-based sequencing of v3
Uploaded: 2010-12-27T18:00:00
Duration: 11 min 10 s
Description: Watch this Scientific Journal Video about Genotypic Inference of HIV-1 Tropism Using Population-based Sequencing of V3 at JoVE.com

Development of this assay was supported by Viiv Healthcare and the Canadian Institutes of Health Research (CIHR) and through a GlaxoSmithKline/CIHR Chair in Clinical Virology for Dr. Harrigan.
Support provided by Pfizer and ViiV Healthcare.

<ol>
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P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=HIV-1+entry+into+CD4++cells+is+mediated+by+the+chemokine+receptor+CC-CKR-5.">HIV-1 entry into CD4+ cells is mediated by the chemokine receptor CC-CKR-5.</a> Nature. 381, 667-673 (1996).</li><li>Dorr, P., Westby, M., Dobbs, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Maraviroc+(UK-427,857),+a+potent,+orally+bioavailable,+and+selective+small-molecule+inhibitor+of+chemokine+receptor+CCR5+with+broad-spectrum+anti-human+immunodeficiency+virus+type+1+activity.">Maraviroc (UK-427,857), a potent, orally bioavailable, and selective small-molecule inhibitor of chemokine receptor CCR5 with broad-spectrum anti-human immunodeficiency virus type 1 activity.</a> Antimicrob. Agents Chemother. 49, 4721-4732 (2005).</li><li>Gulick, R. M., Lalezari, J., Goodrich, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Maraviroc+for+previously+treated+patients+with+R5+HIV-1+infection.">Maraviroc for previously treated patients with R5 HIV-1 infection.</a> N. Engl. J. Med. 359, 1429-1441 (2008).</li><li>Cooper, D. A., Heera, J., Goodrich, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Maraviroc+versus+efavirenz,+both+in+combination+with+zidovudine/lamivudine,+for+the+treatment+of+antiretroviral-na&#237;ve+subjects+with+CCR5-tropic+HIV-1.">Maraviroc versus efavirenz, both in combination with zidovudine/lamivudine, for the treatment of antiretroviral-na&#237;ve subjects with CCR5-tropic HIV-1.</a> J. Infect. Dis. 201, 803-813 (2010).</li><li>Low, A. J., McGovern, R. A., Harrigan, P. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Trofile+HIV+co-receptor+usage+assay.">Trofile HIV co-receptor usage assay.</a> Expert Opin. Med. Diagnostics. 3, 181-191 (2000).</li><li>Sing, T., Low, A. J., Beerenwinkel, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Predicting+HIV+co-receptor+usage+based+on+genetic+and+clinical+covariates.">Predicting HIV co-receptor usage based on genetic and clinical covariates.</a> Antiviral Ther. 12, 1097-1106 (2007).</li><li>Harrigan, P. R., McGovern, R., Dong, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Screening+for+HIV+tropism+using+population-based+V3+genotypic+analysis:+a+retrospective+virological+outcome+analysis+using+stored+plasma+screening+samples+from+MOTIVATE-1.">Screening for HIV tropism using population-based V3 genotypic analysis: a retrospective virological outcome analysis using stored plasma screening samples from MOTIVATE-1.</a> , (2009).</li><li>Harrigan, P. R., McGovern, R., Dong, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optimization+of+clinically+relevant+cut-points+for+the+determination+of+HIV+co-receptor+usage+to+predict+maraviroc+responses+in+treatment+experienced+(TE)+patients+using+population+V3+genotyping.">Optimization of clinically relevant cut-points for the determination of HIV co-receptor usage to predict maraviroc responses in treatment experienced (TE) patients using population V3 genotyping.</a> , (2009).</li><li>Swenson, L. C., McGovern, R. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optimization+of+clinically+relevant+cutoffs+for+determining+HIV+co-receptor+use+by+population+and+"deep"+sequencing+methods.">Optimization of clinically relevant cutoffs for determining HIV co-receptor use by population and "deep" sequencing methods.</a> , (2009).</li><li>Swenson, L., McGovern, R., Dong, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Phenotypic+screening+for+HIV+tropism+versus+both+population-based+and+"deep"+sequencing.">Phenotypic screening for HIV tropism versus both population-based and "deep" sequencing.</a> , (2009).</li><li>Swenson, L. C., Moores, A., Low, A. J., Thielen, A., Dong, W., Woods, C., Jensen, M. A., Wynhoven, B., Chan, D., Glascock, C., Harrigan, P. 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P. Richard Harrigan has conflicts of interest with ViiV Healthcare, Virco, Merck, Abbott, and Quest. This video-article is sponsored by ViiV Healthcare.

The method presented here is a standard sequencing method applied to tropism testing. The clinical application of HIV envelope V3 loop sequencing to predict viral tropism has until late been limited. This method has been shown, in retrospective analyses of the maraviroc (ViiV Healthcare) clinical trials, to be at minimum equally able to predict viral tropism in comparison to other validated assays used clinically.
There are many benefits to performing genotypic analysis of the V3 loop for tropism prediction. First and foremost, this procedure can be performed at any facility with operational sequencing equipment, greatly increasing the accessibility and reducing the turnaround time of tropism testing. In comparison, the phenotypic Enhanced Sensitivity Trofile Assay (ESTA) (Monogram Biosciences), which has served as the gold standard for tropism testing, is performed at one centre in Southern California. Additional benefits include the requirement of less starting material and a minimum required plasma viral load of 500copies/mL. As well, the operational costs of running the genotypic assay are relatively low in comparison to those of a phenotypic assay. The use of the ReCall software in particular eliminates the requirement for manual sequence review, which tends to be a labour intensive part of genotype analyses.
The method presented here is fairly straightforward, with no particular step outweighing another in importance. We do suggest running PCR and sequencing in triplicate to increase the odds of capturing minority species within the viral population of a sample. Replicates greater than three can be performed, however we have found triplicates to be both efficient and reliable. We also suggest using the One-Step Reverse Transcriptase PCR Kit (Qiagen) which performs both RT-PCR and first round PCR in the same reaction while maintaining high sensitivity and specificity.

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		<thead>
		<tr>
		<th>Material Name</th>
		<th>Type</th>
		<th>Company</th>
		<th>Catalogue Number</th>
		<th>Comment</th>
		</tr>
		</thead>
		<tbody>
		
<tr>
<td>RNA extraction using NucliSens easyMAG version 1.0</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>NucliSens easyMAG Magnetic Silica</td>
<td>&nbsp;</td>
<td>bioMerieux</td>
<td>cat. # 280133</td>
<td>(48 x 0.6 ml)</td>
</tr>
<tr>
<td>NucliSens easyMAG Lysis Buffer</td>
<td>&nbsp;</td>
<td>bioMerieux</td>
<td>cat. # 280134</td>
<td>(4 x 1000 ml)</td>
</tr>
<tr>
<td>NucliSens easyMAG Extraction Buffer 1</td>
<td>&nbsp;</td>
<td>bioMerieux</td>
<td>cat. # 280130</td>
<td>(4 x 1000 ml)</td>
</tr>
<tr>
<td>NucliSens easyMAG Extraction Buffer 2</td>
<td>&nbsp;</td>
<td>bioMerieux</td>
<td>cat. # 280131</td>
<td>(4 x 1000 ml)</td>
</tr>
<tr>
<td>NucliSens easyMAG Extraction Buffer 3</td>
<td>&nbsp;</td>
<td>bioMerieux</td>
<td>cat. # 280132</td>
<td>(4 x 1000 ml)</td>
</tr>
<tr>
<td>NucliSens easyMAG version 1.0 </td>
<td>&nbsp;</td>
<td>bioMerieux</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>Class II A2 biological safety cabinet</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>One-Step Reverse Transcriptase PCR and Second Round PCR</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>DEPC-treated water</td>
<td>&nbsp;</td>
<td>Ambion Corp.</td>
<td>cat. # 9922</td>
<td>&nbsp;</td>
<tr>
<td>SuperScrip III One-Step RT-PCR System with Platinum Taq High Fidelty</td>
<td>&nbsp;</td>
<td>Invitrogen</td>
<td>cat#12574-035</td>
<td>Kit components used: 
- SuperScript III RT/ Platinum Taq High Fidelty Enzyme Mix 
- 2X Reaction Mix (a buffer containing 0.4mM of each dNTP, 2.4mM MgSO4)</td>
</tr>
<tr>
<td>Expand High Fidelity PCR System</td>
<td>&nbsp;</td>
<td>Roche Diagnostics</td>
<td>cat. # 1 759 078</td>
<td>Kit components used: 
- Expand High Fidelity Buffer 10X conc. with 15 mM MgCl2 (lids labelled 2) 
- Expand HF PCR Enzyme Mix (3.5U/&mu;l) 
- MgCl2 Stock Solution (25mM) (lids labelled 4)</td>
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<tr>
<td>dNTPs: dATP, dGTP, dCTP, dTTP</td>
<td>&nbsp;</td>
<td>Roche Diagnostics</td>
<td>cat. # 11969064001</td>
<td>(100 mM)</td>
</tr>
<tr>
<td>Sucrose</td>
<td>&nbsp;</td>
<td>Sigma</td>
<td>cat. # S0389-500G</td>
<td>&nbsp;</td>
<tr>
<td>Bromophenol blue sodium salt</td>
<td>&nbsp;</td>
<td>Sigma</td>
<td>cat.# B5525</td>
<td>&nbsp;</td>
<tr>
<td>Cresol Red</td>
<td>&nbsp;</td>
<td>Sigma</td>
<td>cat.# 114472-5G</td>
<td>indicator grade</td>
</tr>
<tr>
<td>Thermocycler </td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>Gel Electrophoresis</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>50X TAE buffer</td>
<td>&nbsp;</td>
<td>Invitrogen</td>
<td>cat. # 24710030</td>
<td>(1000 ml) </td>
</tr>
<tr>
<td>SYBR Safe DNA gel stain</td>
<td>&nbsp;</td>
<td>Invitrogen Life Technologies</td>
<td>cat. # S33102</td>
<td>&nbsp;</td>
<tr>
<td>Agarose (ultra pure)</td>
<td>&nbsp;</td>
<td>Invitrogen</td>
<td>cat. # 15510-027</td>
<td>&nbsp;</td>
<tr>
<td>E-Gel Low Range Quantitative DNA Ladder</td>
<td>&nbsp;</td>
<td>Invitrogen Life Technologies</td>
<td>cat. # 12373-031</td>
<td>&nbsp;</td>
<tr>
<td>Reagent Grade Type II water</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>Gel apparatus</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>Sequencing</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>ABI PRISM BigDye Terminator Cycle Sequencing Kit</td>
<td>&nbsp;</td>
<td>Applied Biosciences</td>
<td>cat. # 4337458</td>
<td>(25000 reactions)</td>
</tr>
<tr>
<td>Hi-Di Formamide</td>
<td>&nbsp;</td>
<td>Applied Biosciences</td>
<td>cat. # 4311320</td>
<td>&nbsp;</td>
<tr>
<td>Sodium Acetate (NaOAc)</td>
<td>&nbsp;</td>
<td>Sigma</td>
<td>cat. # S-2889</td>
<td>&nbsp;</td>
<tr>
<td>EDTA</td>
<td>&nbsp;</td>
<td>Sigma-Aldrich</td>
<td>Cat.# 03690-100ML</td>
<td>0.5M, pH=8.0</td>
</tr>
<tr>
<td>TRIZMA Hydrochloride Buffer Solution</td>
<td>&nbsp;</td>
<td>Sigma</td>
<td>cat. # T-2819</td>
<td>1 M, pH 9.0</td>
</tr>
<tr>
<td>Magnesium Chloride (MgCl2)</td>
<td>&nbsp;</td>
<td>Sigma</td>
<td>cat. # M-1028</td>
<td>1 M</td>
</tr>
<tr>
<td>95% Ethanol</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>Running Buffer (10X) with EDTA</td>
<td>&nbsp;</td>
<td>Applied Biosystems</td>
<td>cat. # 4335613</td>
<td>500 mL</td>
</tr>
<tr>
<td>Polymer Pop-7 (25mL) Or Polymer Pop-7 (10mL)</td>
<td>&nbsp;</td>
<td>Applied Biosystems</td>
<td>cat. # 44363929 or cat. # 4352759</td>
<td>&nbsp;</td>
<tr>
<td>3700/3730 BigDye Terminator v3.1 Sequencing Standard Kit</td>
<td>&nbsp;</td>
<td>Applied Biosciences</td>
<td>Cat# 4336943</td>
<td>&nbsp;</td>
<tr>
<td>Thermocycler </td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>Centrifuge with plate holders</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>3730xl DNA Analyzer</td>
<td>&nbsp;</td>
<td>Applied Biosciences</td>
<td>&nbsp;</td>
<td>&nbsp;</td>		</tbody>
		</table>
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genotypic inference of hiv-1 tropism using population-based sequencing of v3

Background: Prior to receiving a drug from CCR5-antagonist class in HIV therapy, a patient must undergo an HIV tropism test to confirm that his or her viral population uses the CCR5 coreceptor for cellular entry, and not an alternative coreceptor. One approach to tropism testing is to examine the sequence of the V3 region of the HIV envelope, which interacts with the coreceptor.
Methods: Viral RNA is extracted from blood plasma. The V3 region is amplified in triplicate with nested reverse transcriptase-PCR. The amplifications are then sequenced and analyzed using the software, RE_Call. Sequences are then submitted to a bioinformatic algorithm such as geno2pheno to infer viral tropism from the V3 region. Sequences are inferred to be non-R5 if their geno2pheno false positive rate falls below 5.75%. If any one of the three sequences from a sample is inferred to be non-R5, the patient is unlikely to respond to a CCR5-antagonist.

Watch this Scientific Journal Video about Genotypic Inference of HIV-1 Tropism Using Population-based Sequencing of V3 at JoVE.com

Genotypic Inference of HIV-1 Tropism Using Population-based Sequencing of V3

HIV tropism can be inferred from the V3 region of the viral envelope. V3 is PCR amplified in triplicate using nested RT-PCR, sequenced, and interpreted using bioinformatic software. Samples with with 1 or more sequence(s) with low g2P scores are classified as non-R5 virus.

Background: Prior to receiving a drug from CCR5-antagonist class in HIV therapy, a patient must undergo an HIV tropism test to confirm that his or her ...

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