8th Conference on Retroviruses and Opportunistic Infections Chicago, IL - February 4 - 8, 2001

Conf Retroviruses Opportunistic Infect 2001 Feb 4-8; 8:280 (abstract no. L5)

Siliciano R
Johns Hopkins Univ Sch of Med, Baltimore, MD

Recent evidence suggests that virus production continues at low levels in HIV-1-infected patients who have responded well to highly active antiretroviral therapy (HAART). The source and clinical significance of this low-level viremia are unclear. It is critical to determine whether low-level viremia results from or leads to the initial evolution of drug resistance. One likely source of this low- level viremia is that latent reservoir for HIV-1. It has been well established that HIV-1 can persist in a latent form in resting CD4+ T cells for very long periods of time. This talk will review recent developments in the study of viral reservoirs that allow persistence of HIV-1 in patients on HAART, focusing on the mechanism by which the latent reservoir in resting CD4+ T cells is established and the mechanisms that are responsible for the extraordinary stability of this reservoir. The relationship between ongoing virus production and the latent reservoir for HIV-1 will be considered. Using a recently developed method for genotypic analysis on patients with <50 copies/ml of plasma HIV-1 RNA, we have shown that there is continued release, for as long as 45 months, of archival drug- sensitive viruses devoid of new resistance mutations selected under HAART. Resistance mutations that were observed reflected prior therapy with non-suppressive one or two drug regimens. Thus, low-level viremia in patients on HAART with <50 copies/ml of HIV-1 RNA results primarily from release of archival, pre-HAART viruses rather than new, HAART-selected, partially resistant mutants. The results indicate that long-term suppression on HAART may be possible. However, the continued release of archival, drug-resistant viruses selected by prior non-suppressive regimens may limit the effectiveness of the "recycling" of antiretroviral drugs.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, Virus Replication, HIV-1, Viremia, HIV-1 Reverse Transcriptase, Antigens, CD4, Human, virology, AIDS

2001-02-04
L5

Copyright © 2001 - Foundation for Retrovirology and Human Health. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health. Licensed (AIDSLINE) from National Library of Medicine.