HIV/AIDS HAART: HAART susceptibilities determined for HIV-1 non-B subtypes

AIDSWEEKLY Plus; Monday, July 3, 2006
Staff Medical Writers

According to recent research from France, "Most studies on antiretroviral (ARV) resistance of human immunodeficiency virus (HIV) have been done on subtype B which only represent a limited proportion of infections worldwide." A study was conducted to understand "baseline susceptibilities to ARVs in non-B strains."

"To explore in greater detail possible intrinsic resistance to antiretroviral drugs in non-B subtypes, phenotypic resistance was tested in 35 non-B (A, D, F. G. J; CRF02, 06, 09, 11, 13) HIV-1 isolates obtained from ARV treatment naive patients.

"The panel includes strains with an increasing number of minor mutations in the protease gene and/or with atypical mutations at positions associated with resistance in protease and RT," said L. Vergne and colleagues at the University of Montpellier.

"We detected phenotypic resistance (fold-change values equal or superior to biological test cut-offs (BCO) in 14 of the 35 strains, 4 strains had decreased in vitro susceptibility to more than one drug. However, it is important to note that in most cases the increased fold-changes were close to the BCOs.

"Phenotypic resistance was observed against each of the three ARV drug classes: ritonavir (n=3), nelfinavir (n=2)7 saquinavir (n=2), zidovudine (n=2), stavudine (n=1), didanosine (n=1); delavirdine (n=6), efavirenz (n=1) and nevirapine (n=1)," scientists reported.

The authors continued, "Some mutations could be associated with decreased in vitro susceptibility: 1 of 3 strains only with mutations M461/L in protease, 1/2 A98S, K101N. V108I V1791, and P236L in reverse transcriptase.

"Interestingly, the presence of an increasing number of minor mutations in the protease gene was not associated with decreased in vitro susceptibility to protease inhibitors."

"It is necessary to continue phenotypic studies on non-subtype B strains to identify the role of all polymorphisms present in protease and RT genes and to optimize interpretation algorithms.

"Data obtained from large, diverse populations of HIV-1 infected individuals is critical for defining and standardizing the quantification of resistance (phenotypic and genotypic testing)," researchers concluded.

Vergne and colleagues published their study in the Journal of Clinical Virology (Natural polymorphism in protease and reverse transcriptase genes and in vitro antiretroviral drug susceptibilities of non-B HIV-1 strains from treatment-naive patients. J Clin Virol. 2006 May;36(1):43-9).

For additional information, contact M. Peeters, IRD, UMR145, 911 Avenue Agropolis, BP 64501, F-34394 Montpellier 01, France.

Publisher contact information for the Journal of Clinical Virology is: Elsevier Science BV, PO Box 211, 1000 AE Amsterdam, Netherlands.

Keywords: Montpellier, France, HIV-1 Non-B Subtypes, Gene Polymorphism, HAART, Drug Resistance & Susceptibility, Phenotype.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Vergne L, Stuyver L, Van Houtte M, et al., “Natural polymorphism in protease and reverse transcriptase genes and in vitro antiretroviral drug susceptibilities of non-B HIV-1 strains from treatment-naive patients”, J Clin Virol. 2006 May;36(1):43-9.

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