在艾滋病毒感染者病毒载量低于检测限制标准的临床实验放大和量化HIV - 1 RNA
Summary
量化血浆中HIV – 1 RNA水平和测序单一的HIV – 1病毒载量低于检测限（50-75拷贝/ ml）与个人的基因组是困难的。在这里，我们描述了如何提取和量化使用实时PCR检测方法能够可靠措施，HIV – 1 RNA下降到0.3拷贝/ ml，以及如何放大由单一的基因组测序的病毒基因组病毒载量非常低的样品，血浆病毒RNA。
Abstract
，获得患者的洞察力病毒动态和病毒宿主相互作用，病毒基因放大和量化，在HIV – 1病毒载量低于检测标准检测的限制（低于50-75拷贝/ ml）感染者HIV – 1 RNA是必要的日志自然控制的感染和抗逆转录病毒联合疗法（CART）的那些。
在这里，我们介绍了如何由单一的基因组测序（SGS协议）13，19和如何准确地量化在与病毒载量低（单拷贝检测（SCA）协议）12，20的患者的HIV – 1 RNA病毒的基因组扩增。
单拷贝检测的实时PCR检测的灵敏度取决于被检测血浆量。如果一个单一的病毒基因组是7毫升血浆中检测到，然后报道RNA拷贝数为0.3拷贝/ ml。该检测RNA提取效率的内部控制测试，并可能扩增DNA或污染控制。测量患者样本一式三份。
，现在已经广泛使用，被视为非劳动密集的3，7，12，14，15的单基因组测序法（SGS）的，是一个限制的稀释检测，其中端点cDNA产物稀释96孔蔓延板。根据泊松分布，不到1 / 3的水井时给予的产品，有一个80％的机会的PCR产物被放大的结果，从一个单一的基因分子。 SGS已超过克隆没有受到重采样和PCR引入重组19偏颇的优势。然而，SCA和SGS的扩增成功取决于引物的设计。两种检测为HIV – 1 B亚型，但可以适应不断变化的引物，探针和标准的其他亚型和基因组的其他地区。
Protocol
1。从大量的血浆提取的RNA 在图1和2提供了一个单拷贝检测（SCA）的概述和单基因组测序（SGS）的协议。 要获得7毫升血浆，旋转约14毫升的血液收集在15毫升EDTA，15分钟，在2600 XG（肝素）无制动收集管。移液器（一定要避免巴菲涂层）为15毫升管的血浆。 如果RNA是单拷贝检测（SCA），秒杀Rous肉瘤病毒内部的病毒粒子控制（RCAS）30000份血浆中提取。 RCAS病毒前准?…
Discussion
艾滋病毒1感染者抗逆转录病毒药物联合治疗（车）或自然控制感染病毒载量非常低，通常约1副本每毫升血浆4，11，12，17，18。自然控制患者的病毒载量，往往个人设置1，2，17点左右波动。检测的灵敏度，此处所描述的高度依赖的血浆输入量。一般来说，我们已与7毫升血浆，但取得了积极的成果，可以从少量的血浆，以及根据实际血浆病毒载量。此处所描述的RNA提取方法“，这?…
Disclosures
The authors have nothing to disclose.
Acknowledgements
作者要感谢的患者参加的HIV – 1的许多研究。
江铃汽车的FM柯比基金会的支持下与美国癌症协会的研究教授。
Materials
| Name of Reagent | Company | Catalogue number | Comments |
| Random hexamers (500 ug/ml) | Promega | C118A | |
| Taqman buffer A | Applied Biosystems | 4304441 | |
| RNAsin (40 U/ul) | Promega | N211B | |
| RT enzyme (200 U/ul) | Strategene | 600107-51 | |
| Amplitaq Gold DNA polymerase | Applied Biosystems | 4311814 | 6-pack |
| Amplitaq 10XGold PCR buffer II | Applied Biosystems | 4311814 | comes with the enzyme |
| Magnesiumcloride 25 mM | Applied Biosystems | 4311814 | comes with the enzyme |
| 1M Tris-HCl buffer, pH 8.0, 5 mM | Invitrogen | AM9855G | |
| Superscript III reverse transcriptase enzyme, 200 U/ul | Invitrogen | 18080-044 | |
| Superscript III 10X buffer | Invitrogen | comes with the enzyme | |
| DTT 100 mM | Invitrogen | comes with the enzyme | |
| Platinum Taq DNA polymerase High Fidelity 5 U/ul | Invitrogen | 11304-102 | |
| 10X High Fidelity PCR Buffer | Invitrogen | 11304-102 | comes with the enzyme |
| Proteinase-K 20 mg/ml | Ambion | 2546 | |
| Guanidinium Thiocyanate solution 6M | FlukaBiochemica | 50983 | |
| Glycogen 20 mg/ml | Roche | 10901393001 | |
| Isopropanol | Sigma-Aldrich | 19516 | |
| Ethanol 70% | Sigma-Aldrich | E702-3 | |
| Molecular grade water | Gibco/Invitrogen | 10977-015 | |
| dNTPs (25 mmol each) | Bioline | BIO-39025 |
| Name of Euipment | Company | Catalogue number | Comments |
| Easy Seal Centrifuge Tubes (16x73mm) | Seaton Scientific | 6041 | |
| White Delrin crowns | Seaton Scientific | 4020 | Caps for the Easy Seal Tubes |
| Tube Rack for Optiseal Bell-Top Tubes, 8.9 ml | Beckman | 361642 | |
| Hex driver ½ inc opening | Seaton Scientific | 4013 | |
| cap removal tupe | Seaton Scientific | 4014 | |
| 5 ml serological pipettes | Costar | 4051 | |
| Pipetboy | any | ||
| 15 ml Transfer pipettes | ISC Bioexpress | P-5005-7 | |
| 5.8 ml Dispossable transfer pipettes, fine tip | VWR | 14670-329 | |
| 15 ml centrifuge tubes | Falcon | ||
| 1 ml centrifuge tubes | any | ||
| Tris buffer Saline tablets | Sigma-Aldrich | T5030-100TAB | |
| Ultracentrifuge and rotor | Sorval | 90SE and T-1270 | |
| 96-well PCR plates | Biorad | HSS-9601 | |
| 50 ml Reagent reservoir | Costar | 4870 | |
| Microamp optical 96-well reaction plate | Applied Biosystems | N801-0560 | |
| Optical plate covers | Applied Biosystems | 4333183 | |
| MicroAmp Optical Compression Pad | Applied Biosystems | 4312639 | |
| Microseal A film | Biorad | MSA-5001 | |
| 2 ml centrifuge tubes | Any | ||
| 1% agarose gels (E-gel, invitrogen) | Invitrogen | G-7008-01 | |
| E-base (Invitrogen) | Invitrogen | EB-M03 |
EDTA Collection tubes any brand
References
- Amara, R. R., Villinger, F., Altman, J. D., Lydy, S. L., O’Neil, S. P., Staprans, S. I., Montefiori, D. C., Xu, Y., Herndon, J. G., Wyatt, L. S. Control of a mucosal challenge and prevention of AIDS by a multiprotein DNA/MVA vaccine. Vaccine. 20, 1949-1955 (2002).
- Dinoso, J., Kim, S., Blankson, J., Siliciano, R. F. Viral Dynamics of Elite Suppressors in HIV-1 Infection. Conference on Retroviruses and Opportunistic Infections. , (2008).
- Dinoso, J. B., Kim, S. Y., Wiegand, A. M., Palmer, S. E., Gange, S. J., Cranmer, L., O’Shea, A., Callender, M., Spivak, A., Brennan, T., Kearney, . Treatment intensification does not reduce residual HIV-1 viremia in patients on highly active antiretroviral therapy. Proc. Natl. Acad. Sci. U.S.A. 106, 9403-9408 (2009).
- Doria-Rose, N. A., Klein, R. M., Manion, M. M., O’Dell, S., Phogat, A., Chakrabarti, B., Hallahan, C. W., Migueles, S. A., Wrammert, J., Ahmed, R., Nason, M., Wyatt, R. T., Mascola, J. R., Connors, M. Frequency and phenotype of human immunodeficiency virus envelope-specific B cells from patients with broadly cross-neutralizing antibodies. J. Virol. 83, 188-199 (2009).
- Dornadula, G., Zhang, H., Uitert, B. V. a. n., Stern, J., Livornese, L., Ingerman, M. J., Witek, J., Kedanis, R. J., Natkin, J., DeSimone, J., Pomerantz, R. J. Residual HIV-1 RNA in blood plasma of patients taking suppressive highly active antiretroviral therapy. JAMA. 282, 1627-1632 (1999).
- Gandhi, R. T., Zheng, L., Bosch, R. J., Chan, E. S., Margolis, D. M., Read, S., Kallungal, B., Palmer, S., Medvik, K., Lederman, M. M., Alatrakchi, N., Jacobson, J. M., Wiegand, A., Kearney, M., Coffin, J. M., Mellors, J. W., Eron, J. J. The effect of raltegravir intensification on low-level residual viremia in HIV-infected patients on antiretroviral therapy: a randomized controlled trial. PLoS medicine. 7, (2010).
- Gay, C., Dibben, O., Anderson, J. A., Stacey, A., Mayo, A. J., Norris, P. J., Kuruc, J. D., Salazar-Gonzalez, J. F., Li, H., Keele, B. F., Hicks, C., Margolis, D., Ferrari, G., Haynes, B., Swanstrom, R. Cross-sectional detection of acute HIV infection: timing of transmission, inflammation and antiretroviral therapy. PLoS One. 6, 19617-19617 (2011).
- Hatano, H., Delwart, E. L., Norris, P. J., Lee, T. H., Dunn-Williams, J., Hunt, P. W., Hoh, R., Stramer, S. L., Linnen, J. M., McCune, J. M., Martin, J. N., Busch, M. P., Deeks, S. G. Evidence for persistent low-level viremia in individuals who control human immunodeficiency virus in the absence of antiretroviral therapy. J. Virol. 83, 329-335 (2009).
- Havlir, D. V., Bassett, R., Levitan, D., Gilbert, P., Tebas, P., Collier, A. C., Hirsch, M. S., Ignacio, C., Condra, J., Gunthard, H. F., Richman, D. D., Wong, J. K. Prevalence and predictive value of intermittent viremia with combination hiv therapy. JAMA. 286, 171-179 (2001).
- Jordan, M. R., Kearney, M., Palmer, S., Shao, W., Maldarelli, F., Coakley, E. P., Chappey, C., Wanke, C., Coffin, J. M. Comparison of standard PCR/cloning to single genome sequencing for analysis of HIV-1 populations. J Virol Methods. 168, 114-120 (2010).
- Kaufmann, D. E., Kavanagh, D. G., Pereyra, F., Zaunders, J. J., Mackey, E. W., Miura, T., Palmer, S., Brockman, M., Rathod, A., Piechocka-Trocha, A., Baker, B., Zhu, B., Gall, S. L. e., Waring, M. T., Ahern, R., Moss, K., Kelleher, A. D. Upregulation of CTLA-4 by HIV-specific CD4+ T cells correlates with disease progression and defines a reversible immune dysfunction. Nat Immunol. 8, 1246-1254 (2007).
- Kearney, M., Maldarelli, F., Shao, W., Margolick, J. B., Daar, E. S., Mellors, J. W., Rao, V., Coffin, J. M., Palmer, S. HIV-1 Population Genetics and Adaptation in Newly Infected Individuals. J. Virol. 83, 2715-2727 (2008).
- Kearney, M., Palmer, S., Maldarelli, F., Shao, W., Polis, M. A., Mican, J., Rock-Kress, D., Margolick, J. B., Coffin, J. M., Mellors, J. W. Frequent polymorphism at drug resistance sites in HIV-1 protease and reverse transcriptase. AIDS. 22, 497-501 (2008).
- Kearney, M., Spindler, J., Shao, W., Maldarelli, F., Palmer, S., Hu, S. L., Lifson, J. D., Kewal Ramani, V. N., Mellors, J. W., Coffin, J. M., Ambrose, Z. Genetic diversity of simian immunodeficiency virus encoding HIV-1 reverse transcriptase persists in macaques despite antiretroviral therapy. Journal of Virology. 85, 1067-1076 (2011).
- Keele, B. F., Giorgi, E. E., Salazar-Gonzalez, J. F., Decker, J. M., Pham, K. T., Salazar, M. G., Sun, C., Grayson, T., Wang, S., Li, H., Wei, X., Jiang, C., Kirchherr, J. L., Gao, F., Anderson, J. A., Ping, L. H., Swanstrom, R. Identification and characterization of transmitted and early founder virus envelopes in primary HIV-1 infection. Proc. Natl. Acad. Sci. U.S.A. , 105-7552 (2008).
- Liu, S. L., Rodrigo, A. G., Shankarappa, R. G., Learn, H., Hsu, L., Davidov, O., Zhao, L. P., Mullins, J. I. HIV quasispecies and resampling. Science. 273, 415-416 (1996).
- Mahalanabis, M., Jayaraman, P., Miura, T., Pereyra, F., Chester, E. M., Richardson, B., Walker, B., Haigwood, N. L. Continuous viral escape and selection by autologous neutralizing antibodies in drug-naive human immunodeficiency virus controllers. J. Virol. 83, 662-672 (2009).
- Migueles, S. A., Connors, M. The Role of CD4(+) and CD8(+) T Cells in Controlling HIV Infection. Curr. Infect. Dis. Rep. 4, 461-467 (2002).
- Palmer, S., Kearney, M., Maldarelli, F., Halvas, E. K., Bixby, C. J., Bazmi, H., Rock, D., Falloon, J., Davey, R. T., Dewar, R. L., Metcalf, J. A., Hammer, S., Mellors, J. W., Coffin, J. M. Multiple, linked human immunodeficiency virus type 1 drug resistance mutations in treatment-experienced patients are missed by standard genotype analysis. J. Clin. Microbiol. 43, 406-413 (2005).
- Palmer, S., Wiegand, A. P., Maldarelli, F., Bazmi, H., Mican, J. M., Polis, M., Dewar, R. L., Planta, A., Liu, S., Metcalf, J. A., Mellors, J. W., Coffin, J. M. New real-time reverse transcriptase-initiated PCR assay with single-copy sensitivity for human immunodeficiency virus type 1 RNA in plasma. J. Clin. Microbiol. 41, 4531-4536 (2003).
Tags
AmplifyingQuantifyingHIV-1 RNAViral LoadsLimit Of DetectionStandard Clinical AssaysViral GenesInsightViral DynamicsVirus Host InteractionsPatientsNatural ControlCombination Antiretroviral Therapy (cART)Single Genome Sequencing (SGS Protocol)Single-copy Assay (SCA Protocol)Real-time PCR AssaySensitivityVolume Of PlasmaRNA Copy NumberInternal Control TestingDNA ContaminationTriplicate MeasurementsSingle-genome Sequencing Assay (SGS)Non-labor IntensiveLimiting Dilution AssayEndpoint Diluted CDNA Product
Cite This Article
Mens, H., Kearney, M., Wiegand, A., Spindler, J., Maldarelli, F., Mellors, J. W., Coffin, J. M. Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays. J. Vis. Exp. (55), e2960, doi:10.3791/2960 (2011).