The R263K Dolutegravir Resistance-Associated Substitution Progressively Decreases HIV-1 Integration

ABSTRACT Human immunodeficiency virus (HIV) infection persists despite decades of active antiretroviral therapy (ART), effectively preventing viral eradication. Treatment decreases plasma viral RNA, but viral DNA persists, mostly integrated within the genome of nucleated blood cells. Viral DNA blood...

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Autores principales:	Thibault Mesplède, Jing Leng, Hanh Thi Pham, Jiaming Liang, Yudong Quan, Yingshan Han, Mark A. Wainberg
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2017
Materias:	R263K human immunodeficiency virus integration Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/fe9d8ae16b984049b95ad2d548b322fc
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spelling	oai:doaj.org-article:fe9d8ae16b984049b95ad2d548b322fc2021-11-15T15:50:58ZThe R263K Dolutegravir Resistance-Associated Substitution Progressively Decreases HIV-1 Integration10.1128/mBio.00157-172150-7511https://doaj.org/article/fe9d8ae16b984049b95ad2d548b322fc2017-05-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mBio.00157-17https://doaj.org/toc/2150-7511ABSTRACT Human immunodeficiency virus (HIV) infection persists despite decades of active antiretroviral therapy (ART), effectively preventing viral eradication. Treatment decreases plasma viral RNA, but viral DNA persists, mostly integrated within the genome of nucleated blood cells. Viral DNA blood levels correlate with comorbidities and the rapidity of viral rebound following treatment interruption. To date, no intervention aiming at decreasing HIV DNA levels below those attained through ART has been successful. This includes use of some integrase inhibitors either as part of ART or in treatment intensification studies. We have argued that using the integrase inhibitor dolutegravir (DTG) in similar studies may yield better results, but this remains to be studied. In treatment-experienced individuals, the most frequent substitution associated with failure with dolutegravir is R263K in integrase. R263K decreases integration both in cell-free and tissue culture assays. We investigated here how integrated DNA levels evolve over time during prolonged infections with R263K viruses. To investigate a potential defect in reverse transcription with R263K, the levels of reverse transcripts were measured by quantitative PCR. We measured HIV type 1 (HIV-1) integration in Jurkat cells over the course of 4-week infections using Alu-mediated quantitative PCR. The results show that R263K did not decrease reverse transcription. Prolonged infections with R263K mutant viruses led to less HIV-1 integrated DNA over time compared to wild-type viruses. These tissue culture results help to explain the absence of the R263K substitution in most individuals experiencing failure with DTG and support studies aiming at longitudinally measuring the levels of integrated DNA in individuals treated with this drug. IMPORTANCE Antiretroviral treatment decreases plasma viral RNA, but HIV DNA persists for decades within infected cells. Studies of nonhuman primates have suggested that reducing retroviral DNA levels might represent a path to eradication. The integrase inhibitor dolutegravir is less susceptible than any other anti-HIV drug to the emergence of resistance in treatment-naive individuals. In treatment-experienced individuals, in contrast, rare cases of treatment failure were commonly associated with emergence of an R263K integrase substitution that confers low-level resistance to dolutegravir. It is unclear why this substitution is not more common in individuals experiencing failure with dolutegravir. We report here that R263K progressively diminishes the levels of integrated HIV-1 DNA in tissue culture over multiple cycles of infection. Our results help to explain aspects of the clinical efficacy of dolutegravir and suggest that this drug may be able to reduce HIV DNA levels within infected individuals compared to other drugs.Thibault MesplèdeJing LengHanh Thi PhamJiaming LiangYudong QuanYingshan HanMark A. WainbergAmerican Society for MicrobiologyarticleR263Khuman immunodeficiency virusintegrationMicrobiologyQR1-502ENmBio, Vol 8, Iss 2 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	R263K human immunodeficiency virus integration Microbiology QR1-502
spellingShingle	R263K human immunodeficiency virus integration Microbiology QR1-502 Thibault Mesplède Jing Leng Hanh Thi Pham Jiaming Liang Yudong Quan Yingshan Han Mark A. Wainberg The R263K Dolutegravir Resistance-Associated Substitution Progressively Decreases HIV-1 Integration
description	ABSTRACT Human immunodeficiency virus (HIV) infection persists despite decades of active antiretroviral therapy (ART), effectively preventing viral eradication. Treatment decreases plasma viral RNA, but viral DNA persists, mostly integrated within the genome of nucleated blood cells. Viral DNA blood levels correlate with comorbidities and the rapidity of viral rebound following treatment interruption. To date, no intervention aiming at decreasing HIV DNA levels below those attained through ART has been successful. This includes use of some integrase inhibitors either as part of ART or in treatment intensification studies. We have argued that using the integrase inhibitor dolutegravir (DTG) in similar studies may yield better results, but this remains to be studied. In treatment-experienced individuals, the most frequent substitution associated with failure with dolutegravir is R263K in integrase. R263K decreases integration both in cell-free and tissue culture assays. We investigated here how integrated DNA levels evolve over time during prolonged infections with R263K viruses. To investigate a potential defect in reverse transcription with R263K, the levels of reverse transcripts were measured by quantitative PCR. We measured HIV type 1 (HIV-1) integration in Jurkat cells over the course of 4-week infections using Alu-mediated quantitative PCR. The results show that R263K did not decrease reverse transcription. Prolonged infections with R263K mutant viruses led to less HIV-1 integrated DNA over time compared to wild-type viruses. These tissue culture results help to explain the absence of the R263K substitution in most individuals experiencing failure with DTG and support studies aiming at longitudinally measuring the levels of integrated DNA in individuals treated with this drug. IMPORTANCE Antiretroviral treatment decreases plasma viral RNA, but HIV DNA persists for decades within infected cells. Studies of nonhuman primates have suggested that reducing retroviral DNA levels might represent a path to eradication. The integrase inhibitor dolutegravir is less susceptible than any other anti-HIV drug to the emergence of resistance in treatment-naive individuals. In treatment-experienced individuals, in contrast, rare cases of treatment failure were commonly associated with emergence of an R263K integrase substitution that confers low-level resistance to dolutegravir. It is unclear why this substitution is not more common in individuals experiencing failure with dolutegravir. We report here that R263K progressively diminishes the levels of integrated HIV-1 DNA in tissue culture over multiple cycles of infection. Our results help to explain aspects of the clinical efficacy of dolutegravir and suggest that this drug may be able to reduce HIV DNA levels within infected individuals compared to other drugs.
format	article
author	Thibault Mesplède Jing Leng Hanh Thi Pham Jiaming Liang Yudong Quan Yingshan Han Mark A. Wainberg
author_facet	Thibault Mesplède Jing Leng Hanh Thi Pham Jiaming Liang Yudong Quan Yingshan Han Mark A. Wainberg
author_sort	Thibault Mesplède
title	The R263K Dolutegravir Resistance-Associated Substitution Progressively Decreases HIV-1 Integration
title_short	The R263K Dolutegravir Resistance-Associated Substitution Progressively Decreases HIV-1 Integration
title_full	The R263K Dolutegravir Resistance-Associated Substitution Progressively Decreases HIV-1 Integration
title_fullStr	The R263K Dolutegravir Resistance-Associated Substitution Progressively Decreases HIV-1 Integration
title_full_unstemmed	The R263K Dolutegravir Resistance-Associated Substitution Progressively Decreases HIV-1 Integration
title_sort	r263k dolutegravir resistance-associated substitution progressively decreases hiv-1 integration
publisher	American Society for Microbiology
publishDate	2017
url	https://doaj.org/article/fe9d8ae16b984049b95ad2d548b322fc
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The R263K Dolutegravir Resistance-Associated Substitution Progressively Decreases HIV-1 Integration

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