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3rd International Workshop on HIV Drug Resistance2-5 August 1994, Kauai, Hawaii, USA |
SEXUAL TRANSMISSION OF ZIDOVUDINE RESISTANT HIV-1
Int Wkshop HIV Drug Res 1994 Aug 2-5;3:22 (abstract no. 21)
A. Imrie1, A. Carr1, C. Duncombe2, J. Vizzard3, N. Zheng1, R. Finlayson4, L. Hurren1, M. Roggensack1, J. Kaldor3, R. Penny1, David A.Cooper1,3, and the Sydney Primary HIV Infection Study Group
lCentre for Immunology, St Vincent‘s Hospital, Sydney; 2Holdsworth House General Practice, Sydney; 3National Centre in HIV Epidimiology and Clinical Research, University of NSW, Sydney; 4Taylor Square Private Clinic, Sydney, Australia
HIV-1 with decreased in-vitro susceptibility to zidovudine (ZDV) may be isolated from patients on prolonged therapy. We examined the frequency with which ZDV resistant variants of HIV-1 were isolated from 27 homosexual men with primary HIV-1 infection (PHI), as well as from 5 sexual partners. ZDV susceptibility was assessed using donor PBMC; selected isolates were analyzed for mutations at codon 215 of the viral RT by selective PCR. Isolates from 5 virus source patients were analyzed for ZDV resistance phenotype and genotype.
HIV-1 with a resistant phenotype and genotype was isolated from one man 19 days after onset of his primary infection illness as well as from his sexual partner, who had commenced ZDV treatment 25 months prior to transmission. Despite ZDV therapy for treatment of PHI, HIV-1 wild-type at codon 215 had replaced the resistant variants within 3 months of transmission.This rate of transmission (1/27, 3.7%) is not significantly different at the 0.05 level from the proportion of people living with HIV-1 infection in Australia who were estimated to have developed zidovudine resistance. 12 months after seroconversion this patient is clinically well, with category A2 HIV disease.
The long term clinical consequences of primary infection with drug resistant variants of HIV-1 remain to be determined.
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1994-08-02
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