Infection with multidrug resistant, dual-tropic HIV-1 and rapid progression to AIDS: a case report
| Autor: | Leslie Berry, Melissa La Mar, Michael P. Mullen, Anita Shet, Amir Horowitz, Neil Parkin, Hiroshi Mohri, Chris Chung, Alexandria Kim, Saurabh Mehandru, Michael A. Poles, Roopa Kalyanaraman, David D. Ho, Patrick Jean-Pierre, Terri Wrin, Daniel Boden, Christos J. Petropoulos, Martin Markowitz |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Receptors CXCR4 Receptors CCR5 viruses Population HIV Infections Drug resistance Virus Replication Virus Acquired immunodeficiency syndrome (AIDS) Drug Resistance Multiple Viral T-Lymphocyte Subsets medicine Humans Seroconversion education education.field_of_study Acquired Immunodeficiency Syndrome biology Transmission (medicine) virus diseases General Medicine biology.organism_classification medicine.disease Virology CD4 Lymphocyte Count Lentivirus Immunology Disease Progression HIV-1 Viral disease |
| Zdroj: | Lancet (London, England). 365(9464) |
| ISSN: | 1474-547X |
| Popis: | Summary Background Rapid progression to AIDS after acute HIV-1 infection, though uncommon, has been noted, as has the transmission of multidrug resistant viruses. Here, we describe a patient in whom these two factors arose concomitantly and assess the effects. Methods We did a case study of a patient with HIV-1 seroconversion. We genotyped the virus and host genetic markers by PCR and nucleotide sequencing. To ascertain the drug susceptibility of our patient's HIV-1 we did phenotypic studies with the PhenoSense assay. We assessed viral coreceptor use via syncytium formation in vitro and with a modified PhenoSense assay. Findings Our patient seems to have been recently infected by a viral variant of HIV-1 resistant to multiple classes of antiretroviral drugs. Furthermore, his virus population is dual tropic for cells that express CCR5 or CXCR4 coreceptor. The infection has resulted in progression to symptomatic AIDS in 4–20 months. Interpretation The intersection of multidrug resistance and rapid development of AIDS in this patient is of concern, especially in view of his case history, which includes high-risk sexual contacts and use of metamfetamine. The public health ramifications of such a case are great. |
| Databáze: | OpenAIRE |
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