HIV-2 Drug Resistance Genotyping from Dried Blood Spots

J Clin Microbiol. 2020 Dec 17;59(1):e02303-20. doi: 10.1128/JCM.02303-20. Print 2020 Dec 17.


The treatment of HIV-2 in resource-limited settings (RLS) is complicated by the limited availability of HIV-2-active antiretroviral drugs and inadequate access to HIV-2 viral load and drug resistance testing. Dried blood spots (DBS)-based drug resistance testing, widely studied for HIV-1, has not been reported for HIV-2 and could present an opportunity to improve care for HIV-2-infected individuals. We selected 150 DBS specimens from ongoing studies of antiretroviral therapy (ART) for HIV-2 infection in Senegal and subjected them to genotypic drug resistance testing. Total nucleic acid was extracted from DBS, reverse transcribed, PCR amplified, and analyzed by population-based Sanger sequencing, and major drug resistance-associated mutations (RAM) were identified. Parallel samples from plasma and peripheral blood mononuclear cells (PBMC) were also genotyped. We obtained 58 protease/reverse transcriptase genotypes. Plasma viral load was significantly correlated with genotyping success (P < 0.001); DBS samples with corresponding plasma viral load >250 copies/ml had a success rate of 86.8%. In paired DBS-plasma genotypes, 83.8% of RAM found in plasma were also found in DBS, and replicate DBS genotyping revealed that a single test detected 86.7% of known RAM. These findings demonstrate that DBS-based genotypic drug resistance testing for HIV-2 is feasible and can be deployed in RLS with limited infrastructure.

Keywords: DBS; HIV-2; antiretroviral therapy; drug resistance; drug resistance testing; human immunodeficiency virus.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Drug Resistance, Viral*
  • Genotype
  • HIV Infections*
  • HIV-2 / genetics
  • Humans
  • Leukocytes, Mononuclear
  • Senegal
  • Specimen Handling
  • Viral Load