Reappearance of an 11-year-old sequence in an HIV-1 infected patient during treatment interruption
Male
0301 basic medicine
Receptors, CXCR4
0303 health sciences
Genotype
Receptors, CCR5
Anti-HIV Agents
HIV Infections
Middle Aged
Genes, env
Genes, pol
Drug Administration Schedule
HIV Long-Term Survivors
3. Good health
03 medical and health sciences
Drug Resistance, Multiple, Viral
Antiretroviral Therapy, Highly Active
Mutation
HIV-1
Humans
Patient Compliance
Phylogeny
DOI:
10.1080/00365540701558706
Publication Date:
2008-01-11T19:42:52Z
AUTHORS (4)
ABSTRACT
HIV-1 from a patient with multi-drug resistant virus was identified as wild type during treatment interruption. The aim of the study was to describe how the viral population is affected by treatment interruptions and use phylogeny to reconstruct the evolutionary pattern. 15 samples covering 13 y and 2 treatment interruptions were analysed in both pol and env. The wild type virus found in the sample from the second treatment interruption in 2002 had not been present as a dominant population since 1994. Phylogeny showed that the 2002 sample was more closely related to wild type sequences than to other sequences sampled in 2002. This indicated that the wild type virus was caused by recruitment from the viral archives rather than reversion of previously circulating resistant strains. A few weeks after re-initiated treatment, virus showed full resistance, indicating that resistant virus was present as a subpopulation and reselected due to higher fitness in the presence of drugs. Phylogeny of env showed that CCR5 and CXCR4 viruses coexist in the patient. In conclusion, the study showed that at all times during infection, virus is archived in the cells and can be recruited when the surrounding environment changes and the archived virus is more fit.
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CITATIONS (4)
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