Continued Production of Drug-Sensitive Human Immunodeficiency Virus Type 1 in Children on Combination Antiretroviral Therapy Who Have Undetectable Viral Loads

• DOI: 10.1128/jvi.78.2.968-979.2004
• Publication Date: 2003-12-23T17:58:17Z
• Authors: Deborah Persaud; George K. Siberry; Aima Ahonkhai; Joleen Kajdas; Daphne Monie; Nancy Hutton; Douglas C. Watson; Thomas C. Quinn; Stuart C. Ray; Robert F. Siliciano
• Keywords: Viremia; Protease inhibitor (pharmacology)

Highly active antiretroviral therapy (HAART) can suppress plasma human immunodeficiency virus type 1 (HIV-1) levels to below the detection limit of ultrasensitive clinical assays. However, HIV-1 persists in cellular reservoirs, and adults, persistent low-level viremia is detected with more sensitive The nature this poorly understood, it unclear whether children on HAART, particularly those who start shortly after birth. We therefore developed a reverse transcriptase PCR (RT-PCR) assay that allows genotyping protease even when present at as low 5 copies RNA/ml. demonstrated Viremia was began HAART early infancy maintained such strong suppression HIV-1-specific antibody responses were absent or minimal. lacked inhibitor resistance mutations despite frequent use nelfinavir, which has mutational barrier resistance. Protease sequences resembled viruses latent reservoir resting CD4(+) T cells. Thus, most clinically undetectable viremia, there continued production without evolution gene.