ARUP's Laboratory Test Directory
| 0055670: Human Immunodeficiency Virus 1, Genotyping |
![[ image for: Drugs and Mutation List]](icon_40.jpg){kind=icon} | Drugs and Mutation List |
| Test Mnemonic: HIV1GENO | |
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Methodology: Reverse Transcription Polymerase Chain Reaction/DNA Sequencing
Performed: Tue-Sat Reported: 5-10 days |
| Specimen Required: | |
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Collect: Two 5 mL lavender (EDTA) or PPT. Remove EDTA plasma from cells ASAP. Centrifuge PPT plasma ASAP.
Transport: 5 mL plasma, frozen. (Min: 2.5 mL) Submit specimen in an ARUP Standard Transport Tube. Submit specimen according to Biological Substance, Category B, shipping guidelines. Pediatric Collection/Transport: Submit specimen according to Biological Substance, Category B, shipping guidelines. Remarks: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered. Remove EDTA plasma from cells ASAP and freeze in a polypropylene tube at -20°C for transport. Spin PPT ASAP and freeze at -20°C or lower for transport. This test may be unsuccessful if the plasma HIV-1 RNA viral load is less than 1,000 HIV-1 RNA copies per mL of plasma. Unacceptable Conditions: Serum, whole blood, or heparinized plasma. Specimens that are thawed or have exposed to repeated freeze/thaw cycles. Stability: After separation from cells: Ambient: 30 minutes; Refrigerated: 2 hours; Frozen: 4 months |
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| Reference Interval: |
| By report |
| Interpretive Data: | |
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Test Information: HIV-1 Genotype HIV-1 Genotype Result Legend: Resistance: Mutations present constitute a high level of genetic evidence for viral resistance Possible Resistance: Mutations present suggest the possibility of viral resistance None: There is insufficient evidence for viral resistance This assay predicts HIV-1 resistance to protease and reverse transcriptase inhibitor anti-retroviral drugs. The entire protease gene and approximately two-thirds of the reverse transcriptase gene of the viral genome are sequenced at ARUP Laboratories using the Viroseq™ HIV-1 Genotyping System kit. Viroseq™ HIV-1 Genotyping software assigns drug resistance based on the sample sequence. The codons used in the algorithm are: Reverse Transcriptase Codons: -Nucleoside Reverse Transcriptase Inhibitor (NRTI) codons: 41, 44, 62, 65, 67, 69, 70, 74, 75, 77, 115, 116, 118, 151, 184, 210, 215, 219 -Nonnucleoside Reverse Transcriptase Inhibitor (NNRTI) codons: 98, 100, 101, 103, 106, 108, 179, 181, 188, 190, 225, 227, 230, 236, 318 Protease Inhibitor (PI) Codons: 10, 13, 20, 23, 24, 30, 32, 33, 35, 36, 43, 45, 46, 47, 48, 50, 53, 54, 58, 66, 69, 71, 73, 74, 77, 82, 83, 84, 88, 90, 91. A patient's response to therapy depends on multiple factors including the percentage of a patient's viral population that is resistant, patient compliance, access to adequate care, optimal dosing, and drug pharmacology issues, including absorption, elimination, and drug interactions. Therefore, this test should be used only in conjunction with clinical presentation and other laboratory markers (e.g., symptoms, treatment history, clinical impressions, results from other tests, etc.) when making therapeutic decisions. Results from different test methods/algorithms may provide different resistance interpretation. This test may be unsuccessful if the plasma HIV-1 RNA viral load is less than 1,000 HIV-1 RNA copies per mL of plasma, as measured with the Roche Amplicor HIV-1 Monitor assay (Roche Diagnostic Systems, Branchburg, NJ). This test does not detect minor HIV-1 populations that are less than approximately 20 percent of the total population. The ARUP HIV-1 Genotyping Assay uses the Viroseq™ HIV-1 Genotyping System Software to identify mutations associated with drug resistance. According to the Viroseq™ software manual, some insertions/deletions may be difficult to detect using this software; therefore, in rare cases, insertions/deletions in the viral sequence may result in an inaccurate drug resistance report. The performance characteristics of this test were determined by ARUP Laboratories, Inc. |
| Note: | |
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HIV-1 genotyping analysis is now available for the following anti-retroviral drugs: Nucleoside Reverse Transcriptase InhibitorsProtease Inhibitors Generic Name Trade Name Code Generic Name Trade Name Code Zidovudine Retrovir® AZT, ZDV Saquinavir Fortovase® SQV Didanosine Videx® DDI Ritonovir Norvir® RTV Tipranavir Aptivus Indinavir Crixivan® IDV Lamivudine Epivir® 3TC Nelfinavir Viracept® NFV Stavudine Zerit® D4T Lopinavir/Ritonavir Kaletra® LPV Abacavir Ziagen® ABC Amprenavir Agenerase® APV Tenofovir Viread® TDF *Fosamprenavir Lexiva® FOS *Emtricitabine Emtriva® FTC *Atazanavir Reyataz® ATV Non-Nucleoside Reverse Transcriptase Inhibitors Generic Name Trade Name Code Nevirapine Viramune® NVP Delavirdine Rescriptor® DLV Efavirenz Sustiva® EFV *These drugs have been added as of September 13, 2004. |
| CPT Code(s): | |
| 87901 |