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AIDS RESEARCH AND HUMAN RETROVIRUSES
Volume 16, Number 15, 2000, pp. 1503–1505
Mary Ann Liebert, Inc.
Short Communication
Development of a One-Tube Multiplex Reverse
Transcriptase-Polymerase Chain Reaction Assay for the
Simultaneous Amplification of HIV Type 1 Group M
gag and env Heteroduplex Mobility Assay Fragments
FATIM CHAM,1,2 LEO HEYNDRICKX, 1 WOUTER JANSSENS, 1,3 KATLEEN VEREECKEN,1
KATHLEEN DE HOUWER, 1 SANDRA COPPENS,1 GERT VAN DER AUWERA,1 HILTON WHITTLE, 2
and GUIDO VAN DER GROEN1
ABSTRACT
The emergence of intersubtype recombinant HIV-1 isolates has made it imperative to analyze different regions of HIV-1 genomes. For this purpose a one-tube multiplex RT-PCR, coamplifying first-round amplicons
that allow amplification of gag and env heteroduplex mobility assay (HMA) fragments from different HIV-1
group M isolates, was developed, starting with plasma samples. The multiplex RT-PCR assay is sensitive: 115
of 136 (84.5%) samples were positive for both gag and env, positive amplification of the gag fragment was observed in 130 of 136 (95.6%) samples, while for the env fragment 119 of 136 (87.5%) tested positive. The multiplex RT-PCR in combination with gag and env HMA makes large-scale HIV-1 subtyping fast, simple, and
more economical.
T
of a reliable and economical screening
technique to track prevalent HIV-1 subtypes and emerging
recombinant isolates worldwide is important in the effort toward developing a protective vaccine. Although full-length sequencing remains the most accurate technique to characterize
viral genomes, it is technically challenging, and expensive, for
use in large-scale studies, especially for developing nations that
are mostly affected by the HIV epidemic. The heteroduplex mobility assay (HMA) based on analysis of selected regions in the
env gene (env HMA) allowed for rapid subtyping of HIV-1 under field conditions.1 An env HMA kit was developed and
widely distributed through the NIH and the WHO/UNAIDS. A
series of training workshops, organized by the WHO/UNAIDS,
was held in developed and developing countries to ensure an
appropriate use of this technique. Various laboratories have successfully used the env HMA, generating important information
on the molecular epidemiology of HIV-1. The scientific eviHE DEVELOPMENT
dence of an increasing global spread of recombinants2 dictated
a need to extend the env HMA method to other parts of the
HIV-1 genome, increasing probabilities of detecting HIV-1 recombinants. For this purpose a gag HMA was developed.3 In
addition to the env HMA kit, the NIH AIDS Reagent Program
(Rockville, MD) foresees integration of a gag HMA kit.
Hence the gag/env heteroduplex mobility assay (gag/env
HMA)1,3,4 remains the method of choice for rapid screening under field conditions of prevalent subtypes, circulating recombinant forms (CRFs),5 and intersubtype recombinant forms
(IRFs)5 in developing countries where vaccine trials are being
prepared. We developed a cost-effective and less labor-intense
multiplex RT-PCR assay that can simultaneously generate firstround amplicons that allow amplification of gag and env HMA
fragments from different HIV-1 group M plasma samples.
An evaluation panel was available, consisting of 136 plasma
samples of HIV-1 group M (A–H), CRF01.AE-, and CRF02.
1 Department
of Microbiology, Institute of Tropical Medicine, B-2000 Antwerp, Belgium.
Research Council Laboratories, Banjul, The Gambia.
3 Flanders Interuniversity Institute for Biotechnology, VIB, B-9052 Ghent, Belgium.
2 Medical
1503
1504
CHAM ET AL.
TABLE 1.
HIV-1
Group M
CRF
IRF
MULTIPLEX RT-PCR ASSAY
Subtypea
(gag/env)
A/A#b
B/B
C/C
D/D
F/F
G/G
H/H
CRF01.AE/A#
CRF02.AG/A #
AND
N
23
30
16
11
3
14
4
2
21
12
Total: 136
AMPLIFICATION
OF
gag/env HMA FRAGMENTS
gag
env
gag and env
22
30
16
10
1
14
3
2
20
12
130 (95.6%)
21
28
12
9
1
14
3
0
20
11
119 (87.5%)
20
28
12
8
1
14
2
0
19
11
115 (84.5%)
Abbreviations: N, Number of plasma samples; CRF, circulating recombinant form; IRF, intersubtype recombinant form.
a Subtypes for env were based on the 700-bp (ES7/ES8) HMA fragments encoding V3–V5,1 and subtypes for gag were
based on the 460-bp (H1G1584-G17) HMA fragment encoding amino acids 264–417 (according to HIV-1 HXB2_Pr55;
http://hiv-web.lanl.gov/).3
b A# , Subtype A could not be differentiated from CRF02.AG by env HMA.
AG-infected patients from different geographic regions (Bénin,
Cameroon, Kenya, Zambia, Belgium), for which a monoplex
reverse transcriptase-polymerase chain reaction (mono-RTPCR) resulted in 100% sensitivity for both gag and env fragments, and for which the gag/env subtype was determined by
HMA (Table 1). Viral loads were unknown for samples taken
in African countries and ranged from 5 3 103 to .7.5 3 105
for samples taken from Belgian individuals. Total RNA was extracted6 starting from 100 ml of plasma. The RNA was stored
in 50 ml of TE buffer (10 mM Tris-HCl, 1 mM EDTA; pH 8)
at 270°C.
One-tube multiplex RT-PCR was performed in a 25-ml reaction volume. To avoid formation of nonspecific PCR fragments, two separate mixtures, stored on ice, were prepared. Mix
1 (15-ml volume) was composed of nuclease-free water, 1.0
mM MgSO4, dATP, dCTP, dGTP, and dTTP (0.2 mM each)
(Access RT-PCR; Promega, Leiden, The Netherlands), gag
primers H1G777 and H 1P202,3 and env primers ED5 and
ED12,1 at a concentration of 1.0 mM each, and 3 ml of template RNA. Mix 2 (10-ml volume) contained 2.5 units of avian
myeloblastosis virus (AMV) RT, 5 units of Tfl DNA polymerase, 53 AMV/Tfl reaction buffer, and nuclease-free water
(Access RT-PCR; Promega). After pooling both mixtures, RTPCR was done at 48°C for 45 min, followed by inactivation of
AMV RT at 94°C for 2 min and 40 cycles of 94°C for 30 sec,
55°C for 30 sec, and 68°C for 2 min, with a final extension at
68°C for 7 min. RT-PCR was done in 0.2-ml thin-walled PCR
tubes (Biozym, Landgraaf, The Netherlands) with a PTC-200
thermocycler (Biozym).
Nested PCR was conducted in separate reaction tubes to amplify the 0.46-kb gag3 or 0.7-kb (ES7–ES8) env1 HMA fragments. Two microliters of first-round PCR product of the multiplex RT-PCR was used as template for each nested reaction.
Second-round amplifications were carried out in a 100-ml reaction volume.3 HMA was performed as described previously.1,3
On testing with the multiplex RT-PCR assay, 115 of 136
(84.5%) were positive for both gag and env, positive amplifi-
cation for the gag fragment being observed in 130 of 136
(95.6%) samples, while for the env fragment 119 of 136 (87.5%)
samples tested positive (Table 1). The difference in sensitivity
for the two assays is not clear and may need further investigation. As compared with multiplex RT-PCR, in mono-RT-PCR
a separate first-round gag and env amplification is performed
under the same reaction conditions as in the multiplex RT-PCR
assay. Therefore, the difference in sensitivity may reflect some
interference between the multiplexed primer pairs during the
RT or the first-round PCR. For the analyzed samples for which
viral load data were available, there was no correlation between
failure of multiplex RT-PCR assay and low viral load.
In a separate study of 30 HIV-1-seropositive individuals from
The Gambia we demonstrated that one-tube multiplex PCR also
works when the target is not cDNA but proviral DNA from uncultured peripheral blood mononuclear cells (PBMCs). From
27 of 30 (90%) samples both gag and env HMA fragments were
amplified simultaneously. In one sample only the gag HMA
fragment could be amplified by multiplex DNA PCR, and in
two samples amplification was negative for both gag and env
HMA in multiplex as well as mono-DNA PCR. 7
Thus when compared with the mono-RT-PCR, one-tube multiplex RT-PCR is cost effective (a 3.5-fold reduction in the price
of reagents), less labor-intensive, and highly sensitive. The application of multiplex RT-PCR, which allows generation of
HMA fragments for env and gag genes, will be important for
the global surveillance of HIV-1 subtypes and recombinants,
which will give important information for the development of
globally effective HIV vaccines.
ACKNOWLEDGMENTS
This work was supported by the Fonds voor Wetenschappelijk Onderzoek, Brussels, Belgium (grant number G.0134.97);
the Flanders Interuniversity Institute for Biotechnology (VIB),
Ghent, Belgium; and the Human Science Foundation (Tokyo,
Japan).
ONE-TUBE MULTIPLEX RT-PCR
REFERENCES
1. Delwart EL, Shpaer EG, Louwagie J, et al.: Genetic relationships
determined by a DNA heteroduplex mobility assay: Analysis of
HIV-1 env genes. Science 1993;262:1257–1261.
2. Carr JK, Foley BT, Leitner T, Salminen MO, Korber B, and McCutchan F: Reference sequences representing the principal genetic diversity of HIV-1 in the pandemic. In: HIV Sequence Database 1998.
Los Alamos National Laboratory, Los Alamos, New Mexico, 1998.
3. Heyndrickx L, Janssens W, Zekeng L, et al.: Simplified strategy for
detection of recombinant HIV-1 group M isolates by gag/env heteroduplex mobility assay. J Virol 2000;74:363–370.
4. Delwart EL, Herring B, Rodrigo AG, and Mullins JI: Genetic subtyping of human immunodeficiency virus using a heteroduplex mobility assay. PCR Methods Appl 1995;4:S202–S216.
5. Robertson DL, Anderson JP, Bradac JA, et al.: HIV-1 nomenclature
proposal—a reference guide to HIV-1 classification. In: HIV Sequence Database 2000. (http://hiv-web.lanl.gov/).
1505
6. Boom R, Sol CJA, Salimans MMM, Jansen CL, Wertheim-van
Dillen PME, and van der Noordaa J: Rapid and simple method
for purification of nucleic acids. J Clin Microbiol 1990;28:495–
503.
7. Cham F, Heyndrickx L, Janssens W, et al.: Study of HIV-1 gag/env
variability in The Gambia using a multiplex DNA PCR. AIDS Res
Hum Retroviruses 2000;16:(in press).
Address reprint requests to:
Wouter Janssens
Department of Microbiology
Institute of Tropical Medicine
Nationalestraat 155
2000 Antwerp, Belgium
E-mail: [email protected]