BACKGROUND: HIV type-1 (HIV-1) protease (PR), reverse transcriptase (RT) and integrase (IN) share the same precursor polyprotein and there is much evidence to suggest functional interactions between IN and RT. We aimed to elucidate whether long-term highly active antiretroviral therapy (HAART) targeting PR and RT could influence raltegravir susceptibility and the fitness of IN. METHODS: HIV-1 IN sequences from 45 heavily antiretroviral-experienced patients with longitudinal samples separated by a median of 10 years were obtained to estimate the rate of nucleotide substitution. IN recombinant viruses were generated from five selected patients. Phenotypic susceptibility to raltegravir was tested in vitro. Changes in viral replication capacity were assayed by growth kinetics and competition of intrapatient IN recombinant viruses. RESULTS: The amino acid substitution rate within IN was 0.06% per year during long-term antiretroviral treatment. Some substitutions had previously been associated with resistance to different IN inhibitors. Despite this, neither the early- nor late-derived IN recombinant viruses showed an increase in phenotypic susceptibility to raltegravir. Moreover, IN recombinant viruses corresponding to IN samples after 10 years of HAART had a replication capacity that was similar to or better than IN recombinant viruses from baseline samples. CONCLUSIONS: HIV-1 IN from longitudinal samples taken from patients treated with IN inhibitor-sparing regimens showed no evidence of genotypic or phenotypic resistance to raltegravir. Additionally, long-term pressure with PR and RT inhibitors did not impair the fitness of HIV-1 IN. These data suggest that current antiretroviral regimens do not diminish the fitness of IN or influence raltegravir efficacy.
BACKGROUND:HIV type-1 (HIV-1) protease (PR), reverse transcriptase (RT) and integrase (IN) share the same precursor polyprotein and there is much evidence to suggest functional interactions between IN and RT. We aimed to elucidate whether long-term highly active antiretroviral therapy (HAART) targeting PR and RT could influence raltegravir susceptibility and the fitness of IN. METHODS:HIV-1 IN sequences from 45 heavily antiretroviral-experienced patients with longitudinal samples separated by a median of 10 years were obtained to estimate the rate of nucleotide substitution. IN recombinant viruses were generated from five selected patients. Phenotypic susceptibility to raltegravir was tested in vitro. Changes in viral replication capacity were assayed by growth kinetics and competition of intrapatient IN recombinant viruses. RESULTS: The amino acid substitution rate within IN was 0.06% per year during long-term antiretroviral treatment. Some substitutions had previously been associated with resistance to different IN inhibitors. Despite this, neither the early- nor late-derived IN recombinant viruses showed an increase in phenotypic susceptibility to raltegravir. Moreover, IN recombinant viruses corresponding to IN samples after 10 years of HAART had a replication capacity that was similar to or better than IN recombinant viruses from baseline samples. CONCLUSIONS:HIV-1 IN from longitudinal samples taken from patients treated with IN inhibitor-sparing regimens showed no evidence of genotypic or phenotypic resistance to raltegravir. Additionally, long-term pressure with PR and RT inhibitors did not impair the fitness of HIV-1 IN. These data suggest that current antiretroviral regimens do not diminish the fitness of IN or influence raltegravir efficacy.
Authors: Maria C Puertas; Maria J Buzón; Mònica Ballestero; Peter Van Den Eede; Bonaventura Clotet; Julia G Prado; Javier Martinez-Picado Journal: J Clin Microbiol Date: 2012-09-26 Impact factor: 5.948
Authors: Michael E Abram; Rebecca M Hluhanich; Derrick D Goodman; Kristen N Andreatta; Nicolas A Margot; Linda Ye; Anita Niedziela-Majka; Tiffany L Barnes; Nikolai Novikov; Xiaowu Chen; Evguenia S Svarovskaia; Damian J McColl; Kirsten L White; Michael D Miller Journal: Antimicrob Agents Chemother Date: 2013-03-25 Impact factor: 5.191
Authors: Joana Cavaco-Silva; Ana Abecasis; Ana Cláudia Miranda; José Poças; Jorge Narciso; Maria João Águas; Fernando Maltez; Isabel Almeida; Isabel Germano; António Diniz; Maria de Fátima Gonçalves; Perpétua Gomes; Celso Cunha; Ricardo Jorge Camacho Journal: PLoS One Date: 2014-03-28 Impact factor: 3.240