2014
DOI: 10.1089/aid.2013.0267
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Viral Tropism and Antiretroviral Drug Resistance in HIV-1 Subtype C-Infected Patients Failing Highly Active Antiretroviral Therapy in Johannesburg, South Africa

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 w… Show more

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Cited by 10 publications
(7 citation statements)
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References 25 publications
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“…However, in the current study, approximately 35% (23/66) of the patients infected with subtype C viruses harbored CXCR4 utilizing viruses and 57% (13/23) of these were X4 exclusively. The mechanism underling the emergence of X4 viruses in treatmentexperienced patients is not yet clear; and the question remains whether the identification of co-receptor switching and the emergence of drug resistance mutations are not coincidental events [35,36]. On the other hand, there is data showing that the up regulation of CCR5 is associated with HIV infection, and that this is reversed in the course of treatment [37,38].…”
Section: Discussionmentioning
confidence: 99%
“…However, in the current study, approximately 35% (23/66) of the patients infected with subtype C viruses harbored CXCR4 utilizing viruses and 57% (13/23) of these were X4 exclusively. The mechanism underling the emergence of X4 viruses in treatmentexperienced patients is not yet clear; and the question remains whether the identification of co-receptor switching and the emergence of drug resistance mutations are not coincidental events [35,36]. On the other hand, there is data showing that the up regulation of CCR5 is associated with HIV infection, and that this is reversed in the course of treatment [37,38].…”
Section: Discussionmentioning
confidence: 99%
“…While in the ISS T-002 trial conducted in Italy patients were highly compliant to therapy, compliance was lower in the ISS T-003 study, a finding particularly frequent in Southern Africa where scarce adherence to cART therapy represents a relevant clinical problem since it is associated with disease progression, virus drug resistance and transmission [ 108 111 ]. Of interest, none of the vaccinees non-compliant to cART therapy experienced a decay of CD4 + T cells, and in most of them plasma viremia remained undetectable at week 48 while, in those with detectable viremia, viral load levels were low.…”
Section: Discussionmentioning
confidence: 99%
“…Although the availability of antiretroviral therapies has significantly increased the life expectancy of those living with HIV/ AIDS, drug resistance compromises the effectiveness of current therapeutics (Ketseoglou et al, 2013;Kumar et al, 2014;Li et al, 2012;Masimba et al, 2013;Thiam et al, 2013). Additionally, many drug regimens currently employed to treat HIV/AIDS result in substantial side effects, such as lypodystrophy, hyperglycemia, liver failure, and cardiovascular diseases (Carr and Cooper, 2000;Kalayjian et al, 2012;Max and Sherer, 2000;Towner et al, 2012).…”
Section: Strategies For Therapeutic Applications: Concluding Remarksmentioning
confidence: 99%