Evolution of Human Immunodeficiency Virus Type 1 Populations after Resumption of Therapy following Treatment Interruption and Shift in Resistance Genotype

Jacques Izopet, Corinne Souyris, Allan Hance, Karine Sandres‐Sauné, Muriel Alvarez, Christophe Pasquier, François Clavel, Jacqueline Puel, Patrice Massip
2002 Journal of Infectious Diseases  
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
more » ... arbored 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.
doi:10.1086/340215 pmid:11992288 fatcat:lfcwpdigrreubkoapbacsbaxxe