TY - JOUR
T1 - Infection with multidrug resistant, dual-tropic HIV-1 and rapid progression to AIDS
T2 - A case report
AU - Markowitz, Martin
AU - Mohri, Hiroshi
AU - Mehandru, Saurabh
AU - Shet, Anita
AU - Berry, Leslie
AU - Kalyanaraman, Roopa
AU - Kim, Alexandria
AU - Chung, Chris
AU - Jean-Pierre, Patrick
AU - Horowitz, Amir
AU - La Mar, Melissa
AU - Wrin, Terri
AU - Parkin, Neil
AU - Poles, Michael
AU - Petropoulos, Christos
AU - Mullen, Michael
AU - Boden, Daniel
AU - Ho, David D.
N1 - Funding Information:
This study received funding from the National Institutes of Health (RO1-AI47033, R44-AI048990, and the Acute Infection and Early Disease Research Program, AI41534), Rockefeller University General Clinical Research Center (M01RR00102), and the Columbia-Rockefeller Center for AIDS Research (P30-AI042848).
PY - 2005/3/19
Y1 - 2005/3/19
N2 - 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.
AB - 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.
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U2 - 10.1016/S0140-6736(05)74227-6
DO - 10.1016/S0140-6736(05)74227-6
M3 - Article
C2 - 15781098
AN - SCOPUS:20144365751
SN - 0140-6736
VL - 365
SP - 1031
EP - 1038
JO - Lancet
JF - Lancet
IS - 9464
ER -