Abstract
Reports show that up to 30% of antiretroviral drug-naive patients in Johannesburg have CXCR4-utilizing HIV-1 subtype C. We assessed whether HIV-1 subtype C-infected individuals failing highly active antiretroviral therapy (HAART) have a higher proportion of CXCR4-utilizing viruses compared to antiretroviral drug-naive patients. The V3 loop was sequenced from plasma from 100 randomly selected HAART-failing patients, and tropism was established using predictive algorithms. All patients harbored HIV-1 subtype C with at least one antiretroviral drug resistance mutation. Viral tropism prediction in individuals failing HAART revealed similar proportions (29%) of X4-utilizing viruses compared to antiretroviral drug-naive patients (30%). Findings are in contrast to reports from Durban in which 60% of HAART-failing subjects harbored X4/dual/mixed-tropic viruses. Despite differences in proportions of X4-tropism within South Africa, the high proportion of thymidine analogue mutations (TAMs) and CXCR4-utilizing HIV-1 highlights the need for intensified monitoring of HAART patients and the predicament of diminishing drug options, including CCR5 antagonists, for patients failing therapy.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Anti-Retroviral Agents / pharmacology
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Anti-Retroviral Agents / therapeutic use*
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Antiretroviral Therapy, Highly Active / methods*
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Drug Resistance, Viral*
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Genotype
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HIV Infections / drug therapy
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HIV Infections / virology*
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HIV-1 / drug effects*
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HIV-1 / genetics
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HIV-1 / isolation & purification
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HIV-1 / physiology*
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Humans
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Molecular Sequence Data
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Mutation, Missense
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RNA, Viral / genetics
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Receptors, HIV / metabolism
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Sequence Analysis, DNA
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South Africa
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Treatment Failure
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Viral Tropism*
Substances
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Anti-Retroviral Agents
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RNA, Viral
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Receptors, HIV
Associated data
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