Antiretroviral drug-resistant HIV-2 infection--a new therapeutic dilemma.
HIV-2 drug resistance in a case of dual HIV infection presents a formidable challenge to the treating physician. We report a patient with dual infection on highly active antiretroviral therapy (HAART) since March 2001 presented with clinical failure. Laboratory assays showed undetectable HIV-1 viral RNA copies, but with low CD4 count. Suspecting HIV-2 resistance, specific genotype assays were performed. Mutations at codons M184V and Q151M conferring resistance to nucleoside reverse transcriptase inhibitors (NRTIs) in HIV-1 infection were detected, as were mutations at codons V71I and L90M implying indinavir and nelfinavir resistance as well. Salvage therapy was initiated with good clinical response.
Maniar
Janak K
JK
Department of Infectious Diseases, Jaslok Hospital & Research Centre, Mumbai, Maharashtra, India. jkmaniar@vsnl.com
Damond
Florence
F
Kamath
Ratnakar R
RR
Mandalia
Sundhiya
S
Surjushe
Amar
A
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D024921:Drug Resistance, Multiple, Viral / Q000235:genetics*; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000235:genetics; D015498:HIV-2 / Q000235:genetics*; D006801:Humans; D008297:Male; D009154:Mutation