Prevalence of CXCR4 tropism among antiretroviral-treated HIV-1-infected patients with detectable viremia.
Although CXCR4-tropic viruses are relatively uncommon among untreated human immunodeficiency virus (HIV)-infected individuals except during advanced immunodeficiency, the prevalence of CXCR4-tropic viruses among treated patients with detectable viremia is unknown. To address this issue, viral coreceptor usage was measured with a single-cycle recombinant-virus phenotypic entry assay in treatment-naive and treated HIV-infected participants with detectable viremia sampled from 2 clinic-based cohorts. Of 182 treated participants, 75 (41%) harbored dual/mixed or X4-tropic viruses, compared with 178 (18%) of the 976 treatment-naive participants (P<.001). This difference remained significant after adjustment for CD4+ T cell count and CCR5 Delta 32 genotype. Enrichment for dual/mixed/X4-tropic viruses among treated participants was largely but incompletely explained by lower pretreatment nadir CD4 + T cell counts. CCR5 inhibitors may thus be best strategically used before salvage therapy and before significant CD4 + T cell depletion.
Hunt
Peter W
PW
Positive Health Program, San Francisco General Hospital, San Francisco, CA 94110, USA. phunt@php.ucsf.edu
Harrigan
P Richard
PR
Huang
Wei
W
Bates
Michael
M
Williamson
David W
DW
McCune
Joseph M
JM
Price
Richard W
RW
Spudich
Serena S
SS
Lampiris
Harry
H
Hoh
Rebecca
R
Leigler
Teri
T
Martin
Jeffrey N
JN
Deeks
Steven G
SG
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000378:metabolism* / Q000472:pathogenicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D019718:Receptors, CXCR4 / Q000378:metabolism*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome; D014766:Viremia / Q000188:drug therapy* / Q000821:virology
D019380:Anti-HIV Agents; D012367:RNA, Viral; D019718:Receptors, CXCR4; D018894:Reverse Transcriptase Inhibitors