Fitness Cost of Antiretroviral Drug Resistance Mutations on the <i>pol</i> Gene during Analytical Antiretroviral Treatment Interruption among Individuals Experiencing Virological Failure

HIV cure studies require patients to enter an analytical treatment interruption (ATI). Here, we describe previously unanalyzed data that sheds light on ATI dynamics in PLHIV (People Living with HIV). We present drug resistance mutation dynamics on the pol gene among individuals with antiretroviral v...

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Autores principales:	James R. Hunter, Domingos E. Matos dos Santos, Patricia Munerato, Luiz Mario Janini, Adauto Castelo, Maria Cecilia Sucupira, Hong-Ha M. Truong, Ricardo Sobhie Diaz
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	antiretroviral virologic failure antiretroviral resistance analytical treatment interruption fitness cost Medicine R
Acceso en línea:	https://doaj.org/article/d42c9c0dc62046d5b4a8d0bf4cb6ff46
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spelling	oai:doaj.org-article:d42c9c0dc62046d5b4a8d0bf4cb6ff462021-11-25T18:38:10ZFitness Cost of Antiretroviral Drug Resistance Mutations on the <i>pol</i> Gene during Analytical Antiretroviral Treatment Interruption among Individuals Experiencing Virological Failure10.3390/pathogens101114252076-0817https://doaj.org/article/d42c9c0dc62046d5b4a8d0bf4cb6ff462021-11-01T00:00:00Zhttps://www.mdpi.com/2076-0817/10/11/1425https://doaj.org/toc/2076-0817HIV cure studies require patients to enter an analytical treatment interruption (ATI). Here, we describe previously unanalyzed data that sheds light on ATI dynamics in PLHIV (People Living with HIV). We present drug resistance mutation dynamics on the pol gene among individuals with antiretroviral virological failure who underwent ATI. The study involved a 12-week interruption in antiretroviral therapy (ART), monitoring of viral load, CD4+/CD8+ T cell counts, and sequencing of the pol gene from 38 individuals experiencing virological failure and harboring 3-class resistant HIV strains: nucleoside reverse transcriptase inhibitors (NRTI) non-nucleoside inhibitors (NNRTI), and protease inhibitors (PI). Protease and reverse transcriptase regions of the <i>pol</i> gene were sequenced at baseline before ATI and every four weeks thereafter from PBMCs and at baseline and after 12 weeks from plasma HIV RNA using population-based Sanger sequencing. Average viral load increased 0.559 log<sub>10</sub> copies per milliliter. CD4+ T cell count decreased as soon as ART was withdrawn, an average loss of 99.0 cells/mL. Forty-three percent of the mutations associated with antiretroviral resistance in PBMCs disappeared and fifty-seven percent of the mutations in plasma reverted to wild type, which was less than the 100% reversion expected. In PBMC, the PI mutations reverted more slowly than reverse transcriptase mutations. The patients were projected to need an average of 33.7 weeks for PI to revert compared with 20.9 weeks for NRTI and 19.8 weeks for NNRTI. Mutations in the pol gene can cause virological failure and difficulty in re-establishing effective virological suppression.James R. HunterDomingos E. Matos dos SantosPatricia MuneratoLuiz Mario JaniniAdauto CasteloMaria Cecilia SucupiraHong-Ha M. TruongRicardo Sobhie DiazMDPI AGarticleantiretroviral virologic failureantiretroviral resistanceanalytical treatment interruptionfitness costMedicineRENPathogens, Vol 10, Iss 1425, p 1425 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	antiretroviral virologic failure antiretroviral resistance analytical treatment interruption fitness cost Medicine R
spellingShingle	antiretroviral virologic failure antiretroviral resistance analytical treatment interruption fitness cost Medicine R James R. Hunter Domingos E. Matos dos Santos Patricia Munerato Luiz Mario Janini Adauto Castelo Maria Cecilia Sucupira Hong-Ha M. Truong Ricardo Sobhie Diaz Fitness Cost of Antiretroviral Drug Resistance Mutations on the <i>pol</i> Gene during Analytical Antiretroviral Treatment Interruption among Individuals Experiencing Virological Failure
description	HIV cure studies require patients to enter an analytical treatment interruption (ATI). Here, we describe previously unanalyzed data that sheds light on ATI dynamics in PLHIV (People Living with HIV). We present drug resistance mutation dynamics on the pol gene among individuals with antiretroviral virological failure who underwent ATI. The study involved a 12-week interruption in antiretroviral therapy (ART), monitoring of viral load, CD4+/CD8+ T cell counts, and sequencing of the pol gene from 38 individuals experiencing virological failure and harboring 3-class resistant HIV strains: nucleoside reverse transcriptase inhibitors (NRTI) non-nucleoside inhibitors (NNRTI), and protease inhibitors (PI). Protease and reverse transcriptase regions of the <i>pol</i> gene were sequenced at baseline before ATI and every four weeks thereafter from PBMCs and at baseline and after 12 weeks from plasma HIV RNA using population-based Sanger sequencing. Average viral load increased 0.559 log<sub>10</sub> copies per milliliter. CD4+ T cell count decreased as soon as ART was withdrawn, an average loss of 99.0 cells/mL. Forty-three percent of the mutations associated with antiretroviral resistance in PBMCs disappeared and fifty-seven percent of the mutations in plasma reverted to wild type, which was less than the 100% reversion expected. In PBMC, the PI mutations reverted more slowly than reverse transcriptase mutations. The patients were projected to need an average of 33.7 weeks for PI to revert compared with 20.9 weeks for NRTI and 19.8 weeks for NNRTI. Mutations in the pol gene can cause virological failure and difficulty in re-establishing effective virological suppression.
format	article
author	James R. Hunter Domingos E. Matos dos Santos Patricia Munerato Luiz Mario Janini Adauto Castelo Maria Cecilia Sucupira Hong-Ha M. Truong Ricardo Sobhie Diaz
author_facet	James R. Hunter Domingos E. Matos dos Santos Patricia Munerato Luiz Mario Janini Adauto Castelo Maria Cecilia Sucupira Hong-Ha M. Truong Ricardo Sobhie Diaz
author_sort	James R. Hunter
title	Fitness Cost of Antiretroviral Drug Resistance Mutations on the <i>pol</i> Gene during Analytical Antiretroviral Treatment Interruption among Individuals Experiencing Virological Failure
title_short	Fitness Cost of Antiretroviral Drug Resistance Mutations on the <i>pol</i> Gene during Analytical Antiretroviral Treatment Interruption among Individuals Experiencing Virological Failure
title_full	Fitness Cost of Antiretroviral Drug Resistance Mutations on the <i>pol</i> Gene during Analytical Antiretroviral Treatment Interruption among Individuals Experiencing Virological Failure
title_fullStr	Fitness Cost of Antiretroviral Drug Resistance Mutations on the <i>pol</i> Gene during Analytical Antiretroviral Treatment Interruption among Individuals Experiencing Virological Failure
title_full_unstemmed	Fitness Cost of Antiretroviral Drug Resistance Mutations on the <i>pol</i> Gene during Analytical Antiretroviral Treatment Interruption among Individuals Experiencing Virological Failure
title_sort	fitness cost of antiretroviral drug resistance mutations on the <i>pol</i> gene during analytical antiretroviral treatment interruption among individuals experiencing virological failure
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/d42c9c0dc62046d5b4a8d0bf4cb6ff46
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Fitness Cost of Antiretroviral Drug Resistance Mutations on the <i>pol</i> Gene during Analytical Antiretroviral Treatment Interruption among Individuals Experiencing Virological Failure

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