title: Antiretroviral resistance during successful therapy of HIV type 1 infection.
abstract: HIV type 1 (HIV-1) drug resistance mutations were selected during antiretroviral therapy successfully suppressing plasma HIV-1 RNA to <50 copies/ml. New resistant mutant subpopulations were identified by clonal sequencing analyses of viruses cultured from blood cells. Drug susceptibility tests showed that biological clones of virus with the mutations acquired during successful therapy had increased resistance. Each of the five subjects with new resistant mutants had evidence of some residual virus replication during highly active antiretroviral therapy (HAART), based on transient episodes of plasma HIV-1 RNA > 50 copies/ml and virus env gene sequence changes. Each had received a suboptimal regimen before starting HAART. Antiretroviral-resistant HIV-1 can be selected from residual virus replication during HAART in the absence of sustained rebound of plasma HIV-1 RNA.
authors.affiliation: Infectious Disease Division and AIDS Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129, USA.
authors.forename: J
authors.initials: J
authors.lastname: Martinez-Picado
authors.forename: M P
authors.initials: MP
authors.lastname: DePasquale
authors.forename: N
authors.initials: N
authors.lastname: Kartsonis
authors.forename: G J
authors.initials: GJ
authors.lastname: Hanna
authors.forename: J
authors.initials: J
authors.lastname: Wong
authors.forename: D
authors.initials: D
authors.lastname: Finzi
authors.forename: E
authors.initials: E
authors.lastname: Rosenberg
authors.forename: H F
authors.initials: HF
authors.lastname: Gunthard
authors.forename: L
authors.initials: L
authors.lastname: Sutton
authors.forename: A
authors.initials: A
authors.lastname: Savara
authors.forename: C J
authors.initials: CJ
authors.lastname: Petropoulos
authors.forename: N
authors.initials: N
authors.lastname: Hellmann
authors.forename: B D
authors.initials: BD
authors.lastname: Walker
authors.forename: D D
authors.initials: DD
authors.lastname: Richman
authors.forename: R
authors.initials: R
authors.lastname: Siliciano
authors.forename: R T
authors.initials: RT
authors.lastname: D'Aquila
mesh_terms: D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D004352:Drug Resistance, Microbial / Q000235:genetics*; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics*; D006801:Humans; D008969:Molecular Sequence Data; D009154:Mutation
chemical_list: D019380:Anti-HIV Agents