NEW YORK (Reuters Health) - Mutations detected during HIV treatment interruptions (TI) are often intermittent and do not seem to affect patients’ ability to repress viral expression when placed back on the same antiretroviral regimen they had used prior to TI, investigators report.
The possibility of viral evolution and resistance has raised concerns about the safety of TI strategies, Dr. Luis J. Montaner and associates note in the November 7th issue of AIDS. In their current study, they genotyped HIV isolated from 11 chronically HIV-1-infected patients during extended or sequential TI.
The patients were taking two nucleoside reverse transcriptase inhibitors and a protease inhibitor or a nonnucleoside reverse transcriptase inhibitor. After one to four TI periods, the patients restarted the same regimens and all were able to suppress HIV.
There was no evidence of drug resistance in five patients. Only one mutation in one patient detected during the first TI persisted during follow-up. The presence of two mutations in four patients identified during the first TI were intermittent or lost altogether during subsequent testing. The two mutations that evolved over the course of the study did not persist after therapy reinitiation.
Thus, “drug-resistance mutations may appear and persist [after short-term TI] only if linked with off-therapy fitness mutations that accelerate viral population expansion when therapy is discontinued,” Dr. Montaner’s group writes.
Moreover, they add, a decision to change antiretroviral therapy should be driven by lack of viral resuppression rather than virus genotyping during TI.
Source: AIDS 2003;17:2337-2343. [ Google search on this article ]
MeSH Headings:Genetic Techniques: Investigative Techniques: Sequence Analysis: Sequence Analysis, RNA: Analytical, Diagnostic and Therapeutic Techniques and EquipmentCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
