Viral tropism and antiretroviral drug resistance in HIV-1 subtype C infected patients initiating or failing highly active antiretroviral therapy in Johannesburg, South Africa

• Published in: Antiviral therapy 2013-01, Vol.18, p.A81-A81
• Main Authors: Ketseoglou, I, Lukhwareni, A, Steegen, K, Carmona, S, Stevens, W S, Papathanasopoulos, M A
• Format: Article
• Language: English
• Subjects: Human immunodeficiency virus 1
• ISSN: 1359-6535

The overall aim was to assess whether HIV-1 subtype C infected individuals failing highly active antiretroviral therapy (HAART) have a higher proportion of CXCR4-utilizing (X4-tropic) viruses compared to antiretroviral drug-naive patients. We have previously shown that up to 30% of antiretroviral drugnaive patients have CXCR4-utilizing HIV-1 subtype C. Genotypic characterization of viral tropism in HIV-1 subtype C could help inform whether CCR5 antagonists should be used as salvage therapy in patients failing HAART or as part of first-line/early regimens for maximum benefit. Samples from patients failing HAART and sent for routine genotyping between January and March 2013 to the Charlotte Maxeke Johannesburg Academic Hospital were available for this study. Interestingly, our findings contrast reports from Durban that showed a significant difference between HAART-failing subjects with X4/dual//mixedtropic viruses compared to HAART-naive subjects. Despite the differences in proportions of X4-tropic viruses in HAART-failing subjects seen within South Africa, the high proportion of TAMs and CXCR4- utilizing HIV-1 viruses highlights the need for intensified monitoring of HAART patients and the predicament of diminishing drug options, including CCR5 antagonists, for patients failing therapy.