title: Compartmentalization of drug resistance-associated mutations in a treatment-naive HIV-infected female.
abstract: Development of a drug-resistant variant of HIV-1 has been one of the major concerns contributing to the transmission of the virus. A 40-year-old woman presented to the clinic with micosis and oral candidiasis. The subject was referred for HIV-1 diagnosis. Subsequent investigations revealed a very low CD4 T cell count (48 cell/microl blood) and high plasma HIV-1 RNA load (4.33 x 10(5) copy/ml). A 1.3-kb pol fragment was sequenced in virus collected from plasma and the vaginal compartment. Plasma virus had no mutation in reverse transcriptase and one mutation in protease (L63P). On the other hand vaginal virus contained L63P and M184V mutations in protease and reverse transcriptase, respectively. These mutations were accompanied by several other mutations in previously identified CTL epitopic regions of the two genes. In the absence of antiretroviral treatment, a drug-resistant mutant was thought to develop because of immune pressure. This is the first report describing the role of immune pressure in the development of a drug-resistant virus.
authors.affiliation: Laboratory of Viral Immunology, Ponce School of Medicine, PuertoRico 00732.
authors.forename: Grissell
authors.initials: G
authors.lastname: Tirado
authors.forename: Gloria
authors.initials: G
authors.lastname: Jove
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Noel
authors.forename: Evelyn
authors.initials: E
authors.lastname: Reyes
authors.forename: Gladys
authors.initials: G
authors.lastname: Sepulveda
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yamamura
authors.forename: Anil
authors.initials: A
authors.lastname: Kumar
mesh_terms: D017088:AIDS-Related Opportunistic Infections; D000328:Adult; D019943:Amino Acid Substitution; D019380:Anti-HIV Agents / Q000494:pharmacology*; D018791:CD4 Lymphocyte Count; D002180:Candidiasis, Oral; D004279:DNA, Viral / Q000737:chemistry; D024882:Drug Resistance, Viral / Q000235:genetics*; D000939:Epitopes / Q000235:genetics; D005260:Female; D005814:Genes, Viral; D015751:Genes, pol; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology*; D016333:HIV Protease / Q000235:genetics; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D009154:Mutation; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D014621:Vagina / Q000821:virology; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D000939:Epitopes; D012367:RNA, Viral; D054303:HIV Reverse Transcriptase; D016333:HIV Protease