87901 Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions

Name of the Procedure:

Infectious Agent Genotype Analysis by Nucleic Acid (DNA or RNA); HIV-1, Reverse Transcriptase and Protease Regions

Summary

This procedure tests for specific genetic variations in the HIV-1 virus. It examines two key regions of the virus, the reverse transcriptase, and protease regions, to understand how the virus may respond to different treatments.

Purpose

• Addresses the medical condition of HIV-1 infection.
• Helps determine the most effective antiretroviral therapy by identifying resistance mutations in the HIV-1 virus.

Indications

• HIV-positive patients with a high viral load.
• Patients experiencing failure in current antiretroviral therapy.
• People newly diagnosed with HIV to guide initial treatment.

Preparation

• No special preparations or fasting required.
• Blood sample is typically required.
• Inform the healthcare provider of any current medications.

Procedure Description

1. Blood samples are collected from the patient.
2. The sample is processed in a laboratory to extract DNA or RNA.
3. Specific regions of the HIV-1 genome (reverse transcriptase and protease regions) are amplified and sequenced.
4. The genetic sequences are analyzed to detect mutations that may confer drug resistance.
   • Equipment includes PCR machines and sequencing technology.
   • No anesthesia or sedation is necessary.

Duration

Typically, it takes a few hours to a few days for the analysis to be completed in the lab.

Setting

Performed in a specialized laboratory equipped for genetic analysis.

Personnel

• Phlebotomist or nurse to draw blood.
• Laboratory technicians or molecular biologists to process and analyze the samples.

Risks and Complications

• Minor discomfort or bruising at the blood draw site.
• Rare risk of infection at the puncture site.
• Laboratory errors, though infrequent, can lead to inaccurate results.

Benefits

• Personalized HIV treatment plans optimized for better outcomes.
• Improved management of HIV medication, reducing the risk of resistance.
• Quick turnaround allows timely decisions on therapy adjustments.

Recovery

• No recovery time needed for the blood draw.
• Patients can resume normal activities immediately after the sample collection.
• Follow-up involves discussing test results with the healthcare provider for further treatment planning.

Alternatives

• Phenotypic resistance testing: assesses the growth of the virus in response to medications.
• Integrated therapy without prior genotype testing, though less precise.
• Pros and cons: Genotypic testing is faster and more specific, but phenotypic testing may be more comprehensive.

Patient Experience

• The patient might feel a small pinch during the blood draw.
• Little to no discomfort after the blood draw.
• Emotional relief from receiving precise treatment recommendations.