Evolution of human immunodeficiency virus type 1 populations after resumption of therapy following treatment interruption and shift in resistance genotype

J Infect Dis. 2002 May 15;185(10):1506-10. doi: 10.1086/340215. Epub 2002 Apr 30.

Abstract

Conventional genotyping of human immunodeficiency virus type 1 often reveals a shift from a drug-resistant genotype to a wild-type genotype after treatment interruption. A real-time polymerase chain reaction-based technique was used to detect minority resistant populations in 13 patients who showed genotype reversion after interruption of treatment for 3 months. Sixty-two percent of patients in whom the V82A and L90M protease mutations were no longer detectable by conventional genotyping still harbored minority resistant variants, in proportions ranging from 0.1% to 21%. None of the patients with these minority resistant variants who received a protease-inhibitor regimen on resumption of therapy had a response to treatment. However, population sequencing and clonal analysis of plasma samples obtained 1-2 months after resumption of treatment revealed the presence of wild-type virus during the initial decline in plasma virus load, which indicates that minority resistant variants were not rapidly selected.

Publication types

  • Comparative Study

MeSH terms

  • Amino Acid Sequence
  • Anti-HIV Agents / therapeutic use
  • Drug Resistance, Viral / genetics
  • Genome, Viral
  • Genotype
  • HIV Infections / drug therapy
  • HIV Infections / virology*
  • HIV Protease / genetics
  • HIV-1 / drug effects
  • HIV-1 / enzymology
  • HIV-1 / genetics*
  • Humans
  • Molecular Sequence Data
  • Mutation
  • Polymerase Chain Reaction
  • RNA-Directed DNA Polymerase / genetics
  • Refusal to Treat
  • Sequence Alignment
  • Sequence Homology, Amino Acid

Substances

  • Anti-HIV Agents
  • RNA-Directed DNA Polymerase
  • HIV Protease