title: Long-term persistence of primary genotypic resistance after HIV-1 seroconversion.
abstract: Primary infection with drug-resistant HIV-1 is well documented. We have followed up patients infected with such viruses to determine the stability of resistance-associated mutations. Fourteen patients who experienced primary infection with genotypic evidence of resistance were followed for up to 3 years. Drug resistance-associated mutations persisted over time in most patients studied. In particular, M41L, T69N, K103N, and T215 variants within reverse transcriptase (RT) and multidrug resistance demonstrated little reversion to wild-type virus. By contrast, Y181C and K219Q in RT, occurring alone, disappeared within 25 and 9 months, respectively. Multidrug resistance in 2 patients was found to be stable for up to 18 months, the maximum period studied. We conclude that certain resistance-associated mutations are highly stable and these data support the recommendation that all new HIV diagnoses in areas where primary resistance may occur should undergo genotyping irrespective of whether the date of seroconversion is known.
authors.affiliation: Royal Sussex County Hospital, Brighton, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Pao
authors.forename: Ushan
authors.initials: U
authors.lastname: Andrady
authors.forename: Janette
authors.initials: J
authors.lastname: Clarke
authors.forename: Gillian
authors.initials: G
authors.lastname: Dean
authors.forename: Susan
authors.initials: S
authors.lastname: Drake
authors.forename: Martin
authors.initials: M
authors.lastname: Fisher
authors.forename: Tanya
authors.initials: T
authors.lastname: Green
authors.forename: Siva
authors.initials: S
authors.lastname: Kumar
authors.forename: Maurice
authors.initials: M
authors.lastname: Murphy
authors.forename: Alan
authors.initials: A
authors.lastname: Tang
authors.forename: Stephen
authors.initials: S
authors.lastname: Taylor
authors.forename: David
authors.initials: D
authors.lastname: White
authors.forename: Gillian
authors.initials: G
authors.lastname: Underhill
authors.forename: Deenan
authors.initials: D
authors.lastname: Pillay
authors.forename: Patricia
authors.initials: P
authors.lastname: Cane
mesh_terms: D019380:Anti-HIV Agents / Q000494:pharmacology*; D024882:Drug Resistance, Viral / Q000235:genetics*; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology; D016333:HIV Protease / Q000235:genetics; D017320:HIV Protease Inhibitors / Q000494:pharmacology*; D054303:HIV Reverse Transcriptase / Q000235:genetics; D006679:HIV Seropositivity; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D009154:Mutation; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology*; D013997:Time Factors
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D054303:HIV Reverse Transcriptase; D016333:HIV Protease