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Trunfio M, Pinnetti C, Arsuffi S, Bai F, Celani L, D'Ettorre G, Vera JH, D'Arminio Monforte A, Focà E, Ghisetti V, Bonora S, Antinori A, Calcagno A. The presence of resistance‐associated mutations in reverse transcriptase gene is associated with cerebrospinal fluid HIV‐1 escape: A multicentric retrospective analysis. J Med Virol 2023; 95:e28704. [PMID: 36967541 DOI: 10.1002/jmv.28704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/07/2023] [Accepted: 03/23/2023] [Indexed: 04/05/2023]
Abstract
Higher risk of cerebrospinal fluid escape (CVE) has been associated with the use of specific antiretroviral (ARV) classes, such as protease inhibitors. We assessed whether archived resistance-associated mutations (RAMs) can mediate this relationship by identifying patients treated with incompletely active antiretroviral regimens. A retrospective multicentric study on 282 adult people with HIV on antiretroviral therapy (ART) and available historical plasma genotype resistance testing (HGRT) for reverse transcriptase (RT) and protease genes between 2001 and 2021. The odds ratio for demographic, clinic-, and ART-related variables and CVE was estimated by multivariable modeling. HGRT-adjusted central nervous system effectiveness penetration (CPE) score was computed in modeling the risk. Median age, plasma VL, and CD4 count were 49 years, <50 copies/mL, and 310 cells/μL. CVE was detected in 51 participants (17.0%). No difference in CVE prevalence was observed according to ART type, number of ARVs or ARV classes. Participants with CVE had more frequently plasma (52.9% vs. 32.1%, p = 0.005) and CSF RAMs in RT (n = 63, 57.1% vs. 28.6%, p = 0.029), but not in protease gene. The presence of plasma RAMs in RT associated with increased odds of CVE in adjusted analyses (aOR 3.9, p < 0.001) and in models restricted to plasma viral load ≤50 copies/mL (n = 202; aOR 4.3, p = 0.003). CVE risk decreased by 40% per each point increase in HGRT-adjusted CPE score in multivariable models (p < 0.001). Rather than the type of ARV classes or of ART regimens, functional mono or dual regimens caused by the presence of RAMs affecting ART components may explain the majority of cases of CVE.
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Affiliation(s)
- Mattia Trunfio
- Unit of Infectious Diseases, Amedeo di Savoia Hospital at Department of Medical Sciences University of Turin Turin Italy
| | - Carmela Pinnetti
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS Rome Italy
| | - Stefania Arsuffi
- Department of Clinical and Experimental Sciences, Division of Infectious and Tropical Diseases, Spedali Civili General Hospital University of Brescia Brescia Italy
| | - Francesca Bai
- Department of Health Sciences, Clinic of Infectious Diseases and Tropical Medicine, S.Paolo Hospital, ASST Santi Paolo e Carlo University of Milan Milan Italy
| | - Luigi Celani
- Department of Public Health and Infectious Diseases Azienda Policlinico Umberto I Rome Italy
| | - Gabriella D'Ettorre
- Department of Public Health and Infectious Diseases Azienda Policlinico Umberto I Rome Italy
| | - Jaime H. Vera
- Department of Global Health and Infection Brighton and Sussex Medical School Brighton UK
| | - Antonella D'Arminio Monforte
- Department of Health Sciences, Clinic of Infectious Diseases and Tropical Medicine, S.Paolo Hospital, ASST Santi Paolo e Carlo University of Milan Milan Italy
| | - Emanuele Focà
- Department of Clinical and Experimental Sciences, Division of Infectious and Tropical Diseases, Spedali Civili General Hospital University of Brescia Brescia Italy
| | - Valeria Ghisetti
- Molecular Biology and Microbiology Unit, Amedeo di Savoia Hospital ASL Città di Torino Turin Italy
| | - Stefano Bonora
- Unit of Infectious Diseases, Amedeo di Savoia Hospital at Department of Medical Sciences University of Turin Turin Italy
| | - Andrea Antinori
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS Rome Italy
| | - Andrea Calcagno
- Unit of Infectious Diseases, Amedeo di Savoia Hospital at Department of Medical Sciences University of Turin Turin Italy
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CNS Considerations in ART Simplification Strategies. Curr HIV/AIDS Rep 2021; 18:549-557. [PMID: 34739699 DOI: 10.1007/s11904-021-00580-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE OF THE REVIEW This review summarizes current knowledge on central nervous system (CNS) considerations in ART simplification strategies. RECENT FINDINGS Antiretroviral therapies (ART) showing efficacy in plasma will usually show efficacy in the cerebrospinal fluid (CSF). ART simplification may virologically fail if the new regimen has less than two active drugs, the genetic barrier of drugs is not high, and the patient may harbour archived resistance. Dual therapies including a boosted protease inhibitor (PI) or dolutegravir (DTG) are generally effective from the CNS perspective. In cases of related neurotoxicity, switching from either efavirenz (EFV) or DTG to another equally effective drug with better CNS tolerability usually leads to complete resolution of CNS symptoms. However, improvement may be incomplete when factors other than ART that cannot be easily modified are involved.
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Lin SP, Calcagno A, Letendre SL, Ma Q. Clinical Treatment Options and Randomized Clinical Trials for Neurocognitive Complications of HIV Infection: Combination Antiretroviral Therapy, Central Nervous System Penetration Effectiveness, and Adjuvants. Curr Top Behav Neurosci 2020; 50:517-545. [PMID: 33604875 DOI: 10.1007/7854_2020_186] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The etiology and pathogenesis of human immunodeficiency virus type-I (HIV)-associated neurocognitive disorders (HAND) remain undetermined and are likely the produce of multiple mechanisms. This can mainly include neuronal injury from HIV, inflammatory processes, and mental health issues. As a result, a variety of treatment options have been tested including NeuroHIV-targeted regimens based on the central nervous system (CNS) penetration effectiveness (CPE) of antiretroviral therapy (ART) and adjuvant therapies for HAND. NeuroHIV-targeted ART regimens have produced consistent and statistically significant HIV suppression in the CNS, but this is not the case for cognitive and functional domains. Most adjuvant therapies such as minocycline, memantine, and selegiline have negligible benefit in the improvement of cognitive function of people living with HIV (PLWH) with mild to moderate neurocognitive impairment. Newer experimental treatments have been proposed to target cognitive and functional symptoms of HAND as well as potential underlying pathogenesis. This review aims to provide an analytical overview of the clinical treatment options and clinical trials for HAND by focusing on NeuroHIV-targeted ART regimen development, CPE, and adjuvant therapies.
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Affiliation(s)
- Shih-Ping Lin
- Department of Pharmacy Practice, University at Buffalo, Buffalo, NY, USA.,Taichung Veterans General Hospital, Taichung, Taiwan
| | - Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Scott L Letendre
- Department of Medicine and Psychiatry, HIV Neurobehavioral Research Center, University of California San Diego, San Diego, CA, USA
| | - Qing Ma
- Department of Pharmacy Practice, University at Buffalo, Buffalo, NY, USA.
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Patel AK, Patel KK, Gohel S, Kumar A, Letendre S. Incidence of symptomatic CSF viral escape in HIV infected patients receiving atazanavir/ritonavir (ATV/r)-containing ART: a tertiary care cohort in western India. J Neurovirol 2018; 24:498-505. [PMID: 29691760 DOI: 10.1007/s13365-018-0642-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 03/17/2018] [Accepted: 04/10/2018] [Indexed: 12/11/2022]
Abstract
This single-center study attempts to quantify the incidence of symptomatic CSF viral escape (CSFVE) in patients receiving atazanavir/r (ATV/r)-containing regimen. We performed a retrospective analysis of patients receiving ATV/r-containing ART who were diagnosed with symptomatic CSFVE from August 2012 to January 2017. Primary objective was to assess the incidence of symptomatic CSFVE in patients receiving ATV/r-containing ART in clinical practice. Incidence rates were calculated by dividing the number of patients who experienced CSFVE by the number of person-months at risk and summarized as per 10,000 (ten thousand) person-months at risk. Nine hundred thirty-three patients receiving ATV/r containing ART with a total of 36,068 person-months of follow-up were included. Incidence rate of symptomatic CSFVE was 4.4 per 10,000 person-months (95% CI 2.7 to 7.2). The incidence of CSFVE was 9.5 per 10,000 person-months (95% CI 5.7 to 15.7) when the nadir CD4 count was ≤ 200 compared to 0.49 (95% CI 0.07 to 3.5) with a nadir CD4 count > 200 (IRR 19.1 (95% CI 2.93 to 802.8), p < 0.0001). Nadir CD4 count ≤ 200 was associated with substantially increased risk of symptomatic CSFVE, further strengthening efforts to diagnose and treat patients early in disease.
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Affiliation(s)
- Atul K Patel
- Infectious Diseases Clinic, "VEDANTA" Institute of Medical Sciences, 3rd Floor Navrangpura, Ahmedabad, 380009, India.
| | - Ketan K Patel
- Infectious Diseases Clinic, "VEDANTA" Institute of Medical Sciences, 3rd Floor Navrangpura, Ahmedabad, 380009, India
| | - Swati Gohel
- Infectious Diseases Clinic, "VEDANTA" Institute of Medical Sciences, 3rd Floor Navrangpura, Ahmedabad, 380009, India
| | - Ambuj Kumar
- Division and Center for Evidence Based Medicine and Outcomes Research: Department of Internal Medicine, University of South Florida, Tampa, FL, 33612, USA
| | - Scott Letendre
- HIV Neurobehavioral Research Center, Antiviral Research Center, University of California, San Diego, 150 West Washington Street, San Diego, CA, 92103, USA
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Ene L. Human Immunodeficiency Virus in the Brain-Culprit or Facilitator? Infect Dis (Lond) 2018; 11:1178633717752687. [PMID: 29467577 PMCID: PMC5815409 DOI: 10.1177/1178633717752687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/15/2017] [Indexed: 01/21/2023] Open
Abstract
Introduction: Human immunodeficiency virus (HIV) enters the brain early, where it can persist, evolve, and become compartmentalized. Central nervous system (CNS) disease can be attributed to HIV alone or to the complex interplay between the virus and other neurotropic pathogens. Aim: The current review aims to describe the direct impact of HIV on the brain as well as its relationship with other pathogens from a practitioner’s perspective, to provide a general clinical overview, brief workup, and, whenever possible, treatment guidance. Methods: A review of PubMed was conducted to identify studies on neuropathogenesis of HIV in relation to host responses. Furthermore, the interaction between the CNS pathogens and the host damage responses were revised in the setting of advanced and also well-controlled HIV infection. Results: Similar to other pathogens, HIV leads to CNS immune activation, inflammation, and viral persistence. Therefore, almost half of the infected individuals present with neurocognitive disorders, albeit mild. Compartmentalized HIV in the CNS can be responsible in a minority of cases for the dramatic presentation of symptomatic HIV escape. Disruption of the immune system secondary to HIV may reactivate latent infections or allow new pathogens to enter the CNS. Opportunistic infections with an inflammatory component are associated with elevated HIV loads in the cerebrospinal fluid and also with greater cognitive impairment. The inflammatory immune reconstitution syndrome associated with CNS opportunistic infections can be a life-threatening condition, which needs to be recognized and managed by efficiently controlling the pathogen burden and timely balanced combination antiretroviral therapy. Latent neurotropic pathogens can reactivate in the brain and mimic HIV-associated severe neurological diseases or contribute to neurocognitive impairment in the setting of stable HIV infection. Conclusions: As HIV can be responsible for considerable brain damage directly or by facilitating other pathogens, more effort is needed to recognize and manage HIV-associated CNS disorders and to eventually target HIV eradication from the brain.
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Affiliation(s)
- Luminita Ene
- HIV Department, "Dr. Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania
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Dravid AN, Natrajan K, Kulkarni MM, Saraf CK, Mahajan US, Kore SD, Rathod NM, Mahajan US, Wadia RS. Discordant CSF/plasma HIV-1 RNA in individuals on virologically suppressive antiretroviral therapy in Western India. Medicine (Baltimore) 2018; 97:e9969. [PMID: 29465595 PMCID: PMC5841989 DOI: 10.1097/md.0000000000009969] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim of this study was to estimate the prevalence of cerebrospinal fluid (CSF)/Plasma HIV-1 RNA discordance in virologically suppressed individuals presenting with incident neurologic symptoms.In this retrospective cohort study conducted between March 1, 2009, and March 1, 2017, HIV-1 infected adults exposed to atleast 12 months of antiretroviral therapy (ART) and having plasma viral load (VL) <1000 copies/mL (virologically suppressed) were included. Among these, individuals presenting with neurologic symptoms during follow-up were assessed for CSF/Plasma HIV-1 RNA discordance by measuring HIV-1 RNA in collected plasma and CSF samples. CSF/plasma HIV-1 RNA discordance was defined as either detectable CSF HIV-1 RNA (VL > 20 copies/mL) with an undetectable plasma RNA (complete viral suppression, VL ≤20 copies/mL) or CSF HIV-1 RNA ≥ 0.5 log10 higher than plasma RNA when plasma VL was between 20 and 1000 copies/mL (low-level viremia, LLV).Out of 1584 virologically suppressed patients, 71 (4.4%) presented with incident neurologic symptoms. Twenty out of 71 (28.2%) patients were diagnosed with CSF/Plasma HIV-1 discordance. Median plasma and CSF VL in patients with discordance was 120 [interquartile range (IQR): <20 to 332.5] and 4250 (IQR: 2550.0- 9615.0) copies/mL, respectively. All 9 individuals in which CSF HIV-1 genotypic resistance testing was done showed mutations that would compromise efficacy of prescribed ART regimen. Prevalence of CSF/plasma HIV-1 RNA discordance was higher among neurologically symptomatic patients with plasma LLV as compared with those with complete viral suppression (70% vs 11.8%, P < .001). The risk of discordance was also greater in patients who received protease inhibitor (PI) containing ART (P < .001) and those on ART regimens with central nervous system (CNS) penetration effectiveness (CPE) value <6 (P = .006).CSF/plasma HIV-1 RNA discordance indicates replication of HIV-1 that has adapted to the CNS or has developed antiretroviral drug resistance. Larger studies should be performed to study incidence of discordance in India. This will help in managing patients presenting with neurologic symptoms on suppressive ART with appropriate neuroeffective therapy.
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Affiliation(s)
- Ameet N. Dravid
- Department of Medicine, Ruby Hall Clinic
- Department of Medicine, Poona Hospital
- Department of Medicine, Noble Hospital
| | | | | | | | | | - Sachin D. Kore
- Department of Dermatology, Ashwini Sahakari Rugnalaya, Solapur
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Parisi SG, Andreis S, Basso M, Cavinato S, Scaggiante R, Franzetti M, Andreoni M, Palù G, Cattelan AM. Time course of cellular HIV-DNA and low-level HIV viremia in HIV-HCV co-infected patients whose HCV infection had been successfully treated with directly acting antivirals. Med Microbiol Immunol 2017; 206:419-428. [PMID: 28864951 DOI: 10.1007/s00430-017-0518-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 08/27/2017] [Indexed: 12/21/2022]
Abstract
This longitudinal study described cellular HIV-DNA changes and their correlation with HIV low-level plasma viremia (LLV) in HIV-HCV co-infected patients on successful antiretroviral and anti-HCV therapy by treatment with direct-acting antivirals (DAA). Thirty-nine patients were examined prior to the start of DAA (T0), after week 12 (T1) and 24 weeks (T2) of anti-HCV therapy. Cellular PBMC HIV-DNA was analysed as an absolute value and as the percentage of increase or decrease from T0 to T2. Patients were classified as having undetectable plasma HIV viraemia (UV) or LLV in the year before the start of anti-HCV treatment and within the T0-T2 study period. Thirty-five patients (89.7%) of the 39 subjects enrolled had the same plasma HIV viraemia control in the year before HCV treatment and in the T0-T2 interval. The HIV-DNA value at T0 and at T2 was higher in patients with LLV than in subjects with UV (p = 0.015 and p = 0.014, respectively). A similar proportion of patients with LLV and UV experienced an increase or decrease of HIV-DNA from T0 to T2. The percentage increase in HIV-DNA value (262.8%) from T0 to T2 was higher compared to the decrease (43.5%) in patients with UV (p = 0.012), and it was higher compared to the percentage increase in HIV-DNA value reported in subjects with LLV (262.8 versus 49%, p = 0.026). HIV-HCV co-infected patients experienced a multifaceted perturbation of cellular HIV-DNA levels within a 24-week period during anti-HCV treatment; the extent of the phenomenon was greater in subjects with UV. Fast HCV-RNA clearance seemed to have a greater influence on the cellular reservoir than on plasma HIV-RNA.
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Affiliation(s)
- Saverio G Parisi
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padua, Italy.
| | - Samantha Andreis
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padua, Italy
| | - Monica Basso
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padua, Italy
| | - Silvia Cavinato
- Infectious Diseases Unit, Padova Hospital, Via Giustiniani, 2, 35128, Padua, Italy
| | - Renzo Scaggiante
- Infectious Diseases Unit, Padova Hospital, Via Giustiniani, 2, 35128, Padua, Italy
| | - Marzia Franzetti
- Infectious Diseases Unit, Padova Hospital, Via Giustiniani, 2, 35128, Padua, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, Tor Vergata University, Viale Oxford, 81, 00133, Rome, Italy
| | - Giorgio Palù
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padua, Italy
| | - Anna Maria Cattelan
- Infectious Diseases Unit, Padova Hospital, Via Giustiniani, 2, 35128, Padua, Italy
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Soriano V, Fernandez-Montero JV, Benitez-Gutierrez L, Mendoza CD, Arias A, Barreiro P, Peña JM, Labarga P. Dual antiretroviral therapy for HIV infection. Expert Opin Drug Saf 2017. [PMID: 28621159 DOI: 10.1080/14740338.2017.1343300] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION For two decades, triple combinations of antiretrovirals have been the standard treatment for HIV infection. The challenges of such lifelong therapy include long-term side effects, high costs and reduced drug adherence. The recent advent of more potent and safer antiretrovirals has renewed the interest for simpler HIV regimens. Areas covered: We discuss the pros and cons of dual antiretroviral therapies in both drug-naïve and in treatment-experienced patients with viral suppression (switch strategy). Expert opinion: Some dual antiretroviral regimens are safe and efficacious, particularly as maintenance therapy. At this time, combinations of dolutegravir plus rilpivirine represent the best dual regimen. Longer follow-up and larger study populations are needed before supporting dolutegravir plus lamivudine. In contrast, dual therapy based on maraviroc is less effective. Although dual regimens with boosted protease inhibitors plus either lamivudine or raltegravir may be effective, they are penalized by metabolic side effects and risk for drug interactions. The newest dual regimens could save money, reduce toxicity and spare drug options for the future. For the first time in HIV therapeutics, less can be more. Dual therapy switching has set up a new paradigm in HIV treatment that uses induction-maintenance.
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Affiliation(s)
- Vicente Soriano
- a Infectious Diseases Unit , La Paz University Hospital & Autonomous University , Madrid , Spain
| | | | | | - Carmen de Mendoza
- c Internal Medicine Department , Puerta de Hierro Research Institute , Majadahonda , Spain
| | - Ana Arias
- c Internal Medicine Department , Puerta de Hierro Research Institute , Majadahonda , Spain
| | - Pablo Barreiro
- a Infectious Diseases Unit , La Paz University Hospital & Autonomous University , Madrid , Spain
| | - José M Peña
- a Infectious Diseases Unit , La Paz University Hospital & Autonomous University , Madrid , Spain
| | - Pablo Labarga
- d Internal Medicine Department , Nuestra Señora de la Paz Hospital , Madrid , Spain
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Widera M, Dirks M, Bleekmann B, Jablonka R, Däumer M, Walter H, Ehret R, Verheyen J, Esser S. HIV-1 persistent viremia is frequently followed by episodes of low-level viremia. Med Microbiol Immunol 2017; 206:203-215. [PMID: 28220254 PMCID: PMC5409919 DOI: 10.1007/s00430-017-0494-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/24/2017] [Indexed: 12/13/2022]
Abstract
After the start of antiretroviral therapy (ART), plasma HIV-RNA levels should fall below the limit of detection (LOD) within 24 weeks. Hence, the prolonged decline of HIV-RNA after ART initiation is defined as persistent viremia (PV). In this retrospective study, we analyzed factors associated with PV. Next-generation sequencing of viral RNA/DNA was performed to study viral evolution and the emergence of drug-resistance mutations in HIV-infected patients with PV (n = 20). In addition, HIV-DNA species, immunological parameters, and clinical data of the patients were analyzed. We found that the possible causes for PV were divers, and both virologic and host parameters of this particular cohort were heterogeneous. We identified viruses with therapy-associated DRMs in six patients (30%); two of these were detected as minority variants. Five patients had sub-optimal drug levels (25%) and the baseline plasma viral loads were relatively high. Strikingly, we observed that >40% of the PV patients finally reaching HIV levels below the LOD later on showed up with episodes of low-level viremia (LLV). However, the amount of PBMC derived HIV-DNA species was not correlated with the likelihood of LLV after PV. According to our data, we conclude that drug-resistant viruses, sub-optimal drug level, and high baseline viral loads might be probable reasons for the prolonged RNA decline only in a sub-set of patients. In the absence of emerging DRMs and/or compliance issues, the clinical implications of PV remain unclear; however, PV appears to be a risk factor for episodes of LLV.
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Affiliation(s)
- Marek Widera
- Institute of Virology, University Hospital, University of Duisburg-Essen, Virchowstr. 179, 45147, Essen, Germany.
| | - Miriam Dirks
- Institute of Virology, University Hospital, University of Duisburg-Essen, Virchowstr. 179, 45147, Essen, Germany
| | - Barbara Bleekmann
- Institute of Virology, University Hospital, University of Duisburg-Essen, Virchowstr. 179, 45147, Essen, Germany
| | - Robert Jablonka
- Clinic of Dermatology, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Martin Däumer
- Institut für Immunologie und Genetik, Kaiserslautern, Germany
| | - Hauke Walter
- Laboratory MIB, Medical Infectiology Center Berlin, Berlin, Germany
| | - Robert Ehret
- Laboratory MIB, Medical Infectiology Center Berlin, Berlin, Germany
| | - Jens Verheyen
- Institute of Virology, University Hospital, University of Duisburg-Essen, Virchowstr. 179, 45147, Essen, Germany
| | - Stefan Esser
- Clinic of Dermatology, University Hospital, University of Duisburg-Essen, Essen, Germany
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Joseph J, Cinque P, Colosi D, Dravid A, Ene L, Fox H, Gabuzda D, Gisslen M, Beth Joseph S, Letendre S, Mukerji S, Nath A, Perez-Valero I, Persaud D, Price R, Rao V, Sacktor N, Swanstrom R, Winston A, Wojna V, Wright E, Spudich S. Highlights of the Global HIV-1 CSF Escape Consortium Meeting, 9 June 2016, Bethesda, MD, USA. J Virus Erad 2016. [DOI: 10.1016/s2055-6640(20)30879-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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