Important note: Information in this article was accurate in April 2001. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, April 16, 2001
Michael Greer, Staff Medical Writer
NewsRx - Antiretroviral therapy changes the predominant viral phenotype in HIV patients by repressing the more virulent strain found in end-stage disease, researchers in New York report.
"Coreceptor usage plays a critical role in HIV-1 disease progression," S. Philpott and colleagues explained in the Journal of Clinical Investigation. "HIV 1 transmitted in vivo generally uses CCR5 (R5), but later CXCR4 (X4) strains may emerge; this shift heralds CD4+ cell depletion and clinical deterioration."
Philpott et al. found that treatment with antiretroviral drugs altered the makeup of HIV populations for the better by favoring the R5 phenotype.
The researchers initiated their study after noting that antiretroviral therapy can often slow the progression of HIV infection even without uniform viremia suppression.
Using cell cloning and gene sequencing to determine viral coreceptor usage, Philpott et al. demonstrated that patients who underwent antiretroviral therapy had a significantly higher proportion of R5 viruses after such treatment. This was true even for patients with viral populations heavily tilted toward the X4 strain, study data showed.
Multivariate analysis revealed that CD4 cell count and plasma HIV RNA load did not affect antiretroviral-induced phenotypic shifts ("Preferential suppression of CXCR4-specific strains of HIV-1 by antiviral therapy," J Clin Invest 2001 Feb;107(4):431-8.
"Hence, combination therapy may lead to a change in phenotypic character as well as in the quantity of HIV 1," Philpott and colleagues concluded. "Shifts in coreceptor usage may thereby contribute to the clinical efficacy of anti-HIV drugs."
The corresponding author for this report is H. Burger, New York State Dept. of Health, Wadsworth Center, 120 New Scotland Avenue, Albany, NY 12208 USA.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
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