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HIV-1 Drug Resistance Profiles in Children and Adults With Viral Load of <50 Copies/mL Receiving Combination Therapy
CONTEXT The continued release of human immunodeficiency virus type 1 (HIV-1) into plasma at very low levels during highly active antiretroviral therapy (HAART) can be detected using specialized techniques, but the nature and significance of this low-level viremia, especially as related to acquisitio...
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| Published in: | JAMA : the journal of the American Medical Association 2001-07, Vol.286 (2), p.196-207 |
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| container_end_page | 207 |
| container_issue | 2 |
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| container_title | JAMA : the journal of the American Medical Association |
| container_volume | 286 |
| creator | Hermankova, Monika Ray, Stuart C Ruff, Christian Powell-Davis, Monique Ingersoll, Roxann D'Aquila, Richard T Quinn, Thomas C Siliciano, Janet D Siliciano, Robert F Persaud, Deborah |
| description | CONTEXT The continued release of human immunodeficiency virus type 1 (HIV-1)
into plasma at very low levels during highly active antiretroviral therapy
(HAART) can be detected using specialized techniques, but the nature and significance
of this low-level viremia, especially as related to acquisition of drug resistance
mutations, are unclear. OBJECTIVE To determine genetic resistance profiles of low-level plasma HIV-1 in
patients with prolonged viral suppression ( |
| doi_str_mv | 10.1001/jama.286.2.196 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_71000142</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>193999</ama_id><sourcerecordid>75339056</sourcerecordid><originalsourceid>FETCH-LOGICAL-a357t-1782a8d3f3a3d47aa243641f2378be06e207359e3cc72bcc061ebb9946cafe33</originalsourceid><addsrcrecordid>eNqF0U1r3DAQBmARUpJt2msglyBC6c0bSSNbEuQSth8JLLSUJT2asSxntdjyRrIL-fdVyZZAL9VlYOZhYF4Rcs7ZkjPGr3c44FLoaimW3FRHZMFL0AWURh-TBWNGF0pqeUreprRj-XFQJ-SUcym10LAg0939Q8Hppzg_0h8u-TRhsI5-j2Pne5eoD3S19X0bXaAYWnrbzv2U6E8_bemDj9jT9YgtHTt6UzK6GvfepethnXdZ53_58Jh7Q-MDTn4MdLN1EffP78ibDvvk3h_qGdl8-bxZ3RXrb1_vV7frAqFUU8GVFqhb6AChlQpRSKgk7wQo3ThWOcFUvtSBtUo01rKKu6YxRlYWOwdwRj6-rN3H8Wl2aaoHn6zrewxunFOt-J9ApPgv5BpAGK0zvPoH7sY5hnxDLTiHyhheZXR5QHMzuLbeRz9gfK7_hp7BhwPAZLHvYo7cp1fHNIiSZXbxwvIXvw4NGGPgN6v9lmI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211369916</pqid></control><display><type>article</type><title>HIV-1 Drug Resistance Profiles in Children and Adults With Viral Load of <50 Copies/mL Receiving Combination Therapy</title><source>JAMA: The Journal of the American Medical Association</source><creator>Hermankova, Monika ; Ray, Stuart C ; Ruff, Christian ; Powell-Davis, Monique ; Ingersoll, Roxann ; D'Aquila, Richard T ; Quinn, Thomas C ; Siliciano, Janet D ; Siliciano, Robert F ; Persaud, Deborah</creator><creatorcontrib>Hermankova, Monika ; Ray, Stuart C ; Ruff, Christian ; Powell-Davis, Monique ; Ingersoll, Roxann ; D'Aquila, Richard T ; Quinn, Thomas C ; Siliciano, Janet D ; Siliciano, Robert F ; Persaud, Deborah</creatorcontrib><description>CONTEXT The continued release of human immunodeficiency virus type 1 (HIV-1)
into plasma at very low levels during highly active antiretroviral therapy
(HAART) can be detected using specialized techniques, but the nature and significance
of this low-level viremia, especially as related to acquisition of drug resistance
mutations, are unclear. OBJECTIVE To determine genetic resistance profiles of low-level plasma HIV-1 in
patients with prolonged viral suppression (<50 copies/mL of plasma HIV-1
RNA) while receiving HAART. DESIGN AND SETTING Cross-sectional study conducted at a US academic hospital from November
1999 to February 2001 using a novel method for amplification of low levels
of viral genomes in plasma. PATIENTS Eighteen HIV-1–infected patients (7 children and 11 adults), enrolled
in a longitudinal study of HIV-1 reservoirs, who had suppression of viral
replication while receiving protease inhibitor–containing combination
therapy. Two patients (1 adult and 1 child) with less optimal suppression
of viral replication were included to assess virus predominating when plasma
HIV-1 RNA levels are low but detectable (<1000 copies/mL). Follow-up analyses
were conducted in 3 patients. MAIN OUTCOME MEASURE Detection of drug resistance mutations in clones amplified from low-level
plasma virus. RESULTS Viral sequences were amplified from 8 of the 18 patients with simultaneous
plasma HIV-1 measurements of less than 50 copies/mL and from 2 patients with
231 and 50 copies/mL. Clones from 3 treatment-naive patients with less than
50 copies/mL of plasma HIV-1 RNA showed continued release, for as long as
42 months, of wild-type drug-sensitive virus. The 7 patients with prior nonsuppressive
therapy, with viral loads below 50 copies/mL and during "blips" to 231 and
64 copies/mL, had only resistance mutations consistent with pre-HAART therapy
(although reverse transcriptase inhibitor mutations may have continued to
occur). New HAART-related mutations were seen in a control patient with prior
viral load levels of about 400 to 1000 copies/mL. For phylogenetic analysis,
sequences were available for both resting CD4+ T cells and plasma
HIV for 7 of 10 patients and showed patient-specific clustering of sequences
and a close relationship between virus in the plasma and the latent reservoir. CONCLUSIONS Based on the samples that could be amplified, low-level viremia in children
and adults receiving HAART with prolonged suppression of viremia to less than
50 copies/mL of HIV-1 RNA may result primarily from archival, pre-HAART virus,
reflecting earlier treatment conditions, and does not appear to require development
of new, HAART-selected mutations reflecting partial resistance to therapy.
Low-level viremia below 50 copies/mL may represent less of a concern regarding
impending drug failure of current HAART regimens. However, the archival drug-resistant
virus may be relevant regarding future treatment strategies.</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.286.2.196</identifier><identifier>PMID: 11448283</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Adult ; Anti-HIV Agents - pharmacology ; Anti-HIV Agents - therapeutic use ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiretroviral Therapy, Highly Active ; Antiviral agents ; Biological and medical sciences ; Child ; Child, Preschool ; Cross-Sectional Studies ; Drug resistance ; Drug Resistance, Microbial - genetics ; Drug therapy ; Female ; Gene Products, pol - genetics ; Genetics ; HIV ; HIV Infections - drug therapy ; HIV Infections - physiopathology ; HIV Infections - virology ; HIV Protease - genetics ; HIV Reverse Transcriptase - genetics ; HIV-1 - drug effects ; HIV-1 - genetics ; Human immunodeficiency virus ; Human immunodeficiency virus 1 ; Humans ; Male ; Medical sciences ; Middle Aged ; Molecular Sequence Data ; Mutation ; Pharmacology. Drug treatments ; Plasma ; RNA, Viral - blood ; Viral Load ; Viremia - diagnosis ; Viremia - physiopathology</subject><ispartof>JAMA : the journal of the American Medical Association, 2001-07, Vol.286 (2), p.196-207</ispartof><rights>2001 INIST-CNRS</rights><rights>Copyright American Medical Association Jul 11, 2001</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a357t-1782a8d3f3a3d47aa243641f2378be06e207359e3cc72bcc061ebb9946cafe33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1083250$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11448283$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hermankova, Monika</creatorcontrib><creatorcontrib>Ray, Stuart C</creatorcontrib><creatorcontrib>Ruff, Christian</creatorcontrib><creatorcontrib>Powell-Davis, Monique</creatorcontrib><creatorcontrib>Ingersoll, Roxann</creatorcontrib><creatorcontrib>D'Aquila, Richard T</creatorcontrib><creatorcontrib>Quinn, Thomas C</creatorcontrib><creatorcontrib>Siliciano, Janet D</creatorcontrib><creatorcontrib>Siliciano, Robert F</creatorcontrib><creatorcontrib>Persaud, Deborah</creatorcontrib><title>HIV-1 Drug Resistance Profiles in Children and Adults With Viral Load of <50 Copies/mL Receiving Combination Therapy</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT The continued release of human immunodeficiency virus type 1 (HIV-1)
into plasma at very low levels during highly active antiretroviral therapy
(HAART) can be detected using specialized techniques, but the nature and significance
of this low-level viremia, especially as related to acquisition of drug resistance
mutations, are unclear. OBJECTIVE To determine genetic resistance profiles of low-level plasma HIV-1 in
patients with prolonged viral suppression (<50 copies/mL of plasma HIV-1
RNA) while receiving HAART. DESIGN AND SETTING Cross-sectional study conducted at a US academic hospital from November
1999 to February 2001 using a novel method for amplification of low levels
of viral genomes in plasma. PATIENTS Eighteen HIV-1–infected patients (7 children and 11 adults), enrolled
in a longitudinal study of HIV-1 reservoirs, who had suppression of viral
replication while receiving protease inhibitor–containing combination
therapy. Two patients (1 adult and 1 child) with less optimal suppression
of viral replication were included to assess virus predominating when plasma
HIV-1 RNA levels are low but detectable (<1000 copies/mL). Follow-up analyses
were conducted in 3 patients. MAIN OUTCOME MEASURE Detection of drug resistance mutations in clones amplified from low-level
plasma virus. RESULTS Viral sequences were amplified from 8 of the 18 patients with simultaneous
plasma HIV-1 measurements of less than 50 copies/mL and from 2 patients with
231 and 50 copies/mL. Clones from 3 treatment-naive patients with less than
50 copies/mL of plasma HIV-1 RNA showed continued release, for as long as
42 months, of wild-type drug-sensitive virus. The 7 patients with prior nonsuppressive
therapy, with viral loads below 50 copies/mL and during "blips" to 231 and
64 copies/mL, had only resistance mutations consistent with pre-HAART therapy
(although reverse transcriptase inhibitor mutations may have continued to
occur). New HAART-related mutations were seen in a control patient with prior
viral load levels of about 400 to 1000 copies/mL. For phylogenetic analysis,
sequences were available for both resting CD4+ T cells and plasma
HIV for 7 of 10 patients and showed patient-specific clustering of sequences
and a close relationship between virus in the plasma and the latent reservoir. CONCLUSIONS Based on the samples that could be amplified, low-level viremia in children
and adults receiving HAART with prolonged suppression of viremia to less than
50 copies/mL of HIV-1 RNA may result primarily from archival, pre-HAART virus,
reflecting earlier treatment conditions, and does not appear to require development
of new, HAART-selected mutations reflecting partial resistance to therapy.
Low-level viremia below 50 copies/mL may represent less of a concern regarding
impending drug failure of current HAART regimens. However, the archival drug-resistant
virus may be relevant regarding future treatment strategies.</description><subject>Adult</subject><subject>Anti-HIV Agents - pharmacology</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Antiviral agents</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cross-Sectional Studies</subject><subject>Drug resistance</subject><subject>Drug Resistance, Microbial - genetics</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Gene Products, pol - genetics</subject><subject>Genetics</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - physiopathology</subject><subject>HIV Infections - virology</subject><subject>HIV Protease - genetics</subject><subject>HIV Reverse Transcriptase - genetics</subject><subject>HIV-1 - drug effects</subject><subject>HIV-1 - genetics</subject><subject>Human immunodeficiency virus</subject><subject>Human immunodeficiency virus 1</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Molecular Sequence Data</subject><subject>Mutation</subject><subject>Pharmacology. Drug treatments</subject><subject>Plasma</subject><subject>RNA, Viral - blood</subject><subject>Viral Load</subject><subject>Viremia - diagnosis</subject><subject>Viremia - physiopathology</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><recordid>eNqF0U1r3DAQBmARUpJt2msglyBC6c0bSSNbEuQSth8JLLSUJT2asSxntdjyRrIL-fdVyZZAL9VlYOZhYF4Rcs7ZkjPGr3c44FLoaimW3FRHZMFL0AWURh-TBWNGF0pqeUreprRj-XFQJ-SUcym10LAg0939Q8Hppzg_0h8u-TRhsI5-j2Pne5eoD3S19X0bXaAYWnrbzv2U6E8_bemDj9jT9YgtHTt6UzK6GvfepethnXdZ53_58Jh7Q-MDTn4MdLN1EffP78ibDvvk3h_qGdl8-bxZ3RXrb1_vV7frAqFUU8GVFqhb6AChlQpRSKgk7wQo3ThWOcFUvtSBtUo01rKKu6YxRlYWOwdwRj6-rN3H8Wl2aaoHn6zrewxunFOt-J9ApPgv5BpAGK0zvPoH7sY5hnxDLTiHyhheZXR5QHMzuLbeRz9gfK7_hp7BhwPAZLHvYo7cp1fHNIiSZXbxwvIXvw4NGGPgN6v9lmI</recordid><startdate>20010711</startdate><enddate>20010711</enddate><creator>Hermankova, Monika</creator><creator>Ray, Stuart C</creator><creator>Ruff, Christian</creator><creator>Powell-Davis, Monique</creator><creator>Ingersoll, Roxann</creator><creator>D'Aquila, Richard T</creator><creator>Quinn, Thomas C</creator><creator>Siliciano, Janet D</creator><creator>Siliciano, Robert F</creator><creator>Persaud, Deborah</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20010711</creationdate><title>HIV-1 Drug Resistance Profiles in Children and Adults With Viral Load of <50 Copies/mL Receiving Combination Therapy</title><author>Hermankova, Monika ; Ray, Stuart C ; Ruff, Christian ; Powell-Davis, Monique ; Ingersoll, Roxann ; D'Aquila, Richard T ; Quinn, Thomas C ; Siliciano, Janet D ; Siliciano, Robert F ; Persaud, Deborah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a357t-1782a8d3f3a3d47aa243641f2378be06e207359e3cc72bcc061ebb9946cafe33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Anti-HIV Agents - pharmacology</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Antiviral agents</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cross-Sectional Studies</topic><topic>Drug resistance</topic><topic>Drug Resistance, Microbial - genetics</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Gene Products, pol - genetics</topic><topic>Genetics</topic><topic>HIV</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - physiopathology</topic><topic>HIV Infections - virology</topic><topic>HIV Protease - genetics</topic><topic>HIV Reverse Transcriptase - genetics</topic><topic>HIV-1 - drug effects</topic><topic>HIV-1 - genetics</topic><topic>Human immunodeficiency virus</topic><topic>Human immunodeficiency virus 1</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Molecular Sequence Data</topic><topic>Mutation</topic><topic>Pharmacology. Drug treatments</topic><topic>Plasma</topic><topic>RNA, Viral - blood</topic><topic>Viral Load</topic><topic>Viremia - diagnosis</topic><topic>Viremia - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hermankova, Monika</creatorcontrib><creatorcontrib>Ray, Stuart C</creatorcontrib><creatorcontrib>Ruff, Christian</creatorcontrib><creatorcontrib>Powell-Davis, Monique</creatorcontrib><creatorcontrib>Ingersoll, Roxann</creatorcontrib><creatorcontrib>D'Aquila, Richard T</creatorcontrib><creatorcontrib>Quinn, Thomas C</creatorcontrib><creatorcontrib>Siliciano, Janet D</creatorcontrib><creatorcontrib>Siliciano, Robert F</creatorcontrib><creatorcontrib>Persaud, Deborah</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hermankova, Monika</au><au>Ray, Stuart C</au><au>Ruff, Christian</au><au>Powell-Davis, Monique</au><au>Ingersoll, Roxann</au><au>D'Aquila, Richard T</au><au>Quinn, Thomas C</au><au>Siliciano, Janet D</au><au>Siliciano, Robert F</au><au>Persaud, Deborah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HIV-1 Drug Resistance Profiles in Children and Adults With Viral Load of <50 Copies/mL Receiving Combination Therapy</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2001-07-11</date><risdate>2001</risdate><volume>286</volume><issue>2</issue><spage>196</spage><epage>207</epage><pages>196-207</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT The continued release of human immunodeficiency virus type 1 (HIV-1)
into plasma at very low levels during highly active antiretroviral therapy
(HAART) can be detected using specialized techniques, but the nature and significance
of this low-level viremia, especially as related to acquisition of drug resistance
mutations, are unclear. OBJECTIVE To determine genetic resistance profiles of low-level plasma HIV-1 in
patients with prolonged viral suppression (<50 copies/mL of plasma HIV-1
RNA) while receiving HAART. DESIGN AND SETTING Cross-sectional study conducted at a US academic hospital from November
1999 to February 2001 using a novel method for amplification of low levels
of viral genomes in plasma. PATIENTS Eighteen HIV-1–infected patients (7 children and 11 adults), enrolled
in a longitudinal study of HIV-1 reservoirs, who had suppression of viral
replication while receiving protease inhibitor–containing combination
therapy. Two patients (1 adult and 1 child) with less optimal suppression
of viral replication were included to assess virus predominating when plasma
HIV-1 RNA levels are low but detectable (<1000 copies/mL). Follow-up analyses
were conducted in 3 patients. MAIN OUTCOME MEASURE Detection of drug resistance mutations in clones amplified from low-level
plasma virus. RESULTS Viral sequences were amplified from 8 of the 18 patients with simultaneous
plasma HIV-1 measurements of less than 50 copies/mL and from 2 patients with
231 and 50 copies/mL. Clones from 3 treatment-naive patients with less than
50 copies/mL of plasma HIV-1 RNA showed continued release, for as long as
42 months, of wild-type drug-sensitive virus. The 7 patients with prior nonsuppressive
therapy, with viral loads below 50 copies/mL and during "blips" to 231 and
64 copies/mL, had only resistance mutations consistent with pre-HAART therapy
(although reverse transcriptase inhibitor mutations may have continued to
occur). New HAART-related mutations were seen in a control patient with prior
viral load levels of about 400 to 1000 copies/mL. For phylogenetic analysis,
sequences were available for both resting CD4+ T cells and plasma
HIV for 7 of 10 patients and showed patient-specific clustering of sequences
and a close relationship between virus in the plasma and the latent reservoir. CONCLUSIONS Based on the samples that could be amplified, low-level viremia in children
and adults receiving HAART with prolonged suppression of viremia to less than
50 copies/mL of HIV-1 RNA may result primarily from archival, pre-HAART virus,
reflecting earlier treatment conditions, and does not appear to require development
of new, HAART-selected mutations reflecting partial resistance to therapy.
Low-level viremia below 50 copies/mL may represent less of a concern regarding
impending drug failure of current HAART regimens. However, the archival drug-resistant
virus may be relevant regarding future treatment strategies.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>11448283</pmid><doi>10.1001/jama.286.2.196</doi><tpages>12</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0098-7484 |
| ispartof | JAMA : the journal of the American Medical Association, 2001-07, Vol.286 (2), p.196-207 |
| issn | 0098-7484 1538-3598 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_71000142 |
| source | JAMA: The Journal of the American Medical Association |
| subjects | Adult Anti-HIV Agents - pharmacology Anti-HIV Agents - therapeutic use Antibiotics. Antiinfectious agents. Antiparasitic agents Antiretroviral Therapy, Highly Active Antiviral agents Biological and medical sciences Child Child, Preschool Cross-Sectional Studies Drug resistance Drug Resistance, Microbial - genetics Drug therapy Female Gene Products, pol - genetics Genetics HIV HIV Infections - drug therapy HIV Infections - physiopathology HIV Infections - virology HIV Protease - genetics HIV Reverse Transcriptase - genetics HIV-1 - drug effects HIV-1 - genetics Human immunodeficiency virus Human immunodeficiency virus 1 Humans Male Medical sciences Middle Aged Molecular Sequence Data Mutation Pharmacology. Drug treatments Plasma RNA, Viral - blood Viral Load Viremia - diagnosis Viremia - physiopathology |
| title | HIV-1 Drug Resistance Profiles in Children and Adults With Viral Load of <50 Copies/mL Receiving Combination Therapy |
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