HIV Treatment Bulletin

Recombination dynamics in case of MDR sub-type D following superinfection with wild-type sub-type B

Simon Collins, HIV i-Base

While research into reinfection is largely driven by expanding number of case studies, Koning and colleagues from the UK described the dynamics of reinfection with wild-type virus, using single genome sequencing (SGS) in both plasma and semen samples.

Sequential plasmas sampling was performed over 87 weeks, with one semen sample, in a treatment naive patient. The initial sub-type D sample at diagnosis showed RT mutations at D67N, K70R, A98G, K101E, Y181C, G190A, T215L and K219E which was maintained at week 34. At 54 weeks, 18/25 genomes remained similar to baseline, with 1/25 wild-type sub-type B and 3/25 recombinant B/D sub-types with variable resistance.

At weeks 85 and 87, only 2/43 genomes related to the baseline sample, 3/43 were drug-sensitive sub-type B and 39/43 were B/D recombinants, only one of which maintain drug resistant mutations.

The single semen sample at week 87 showed 18/21 of genomes sampled to be sub-type B, and the remaining three B/D recombinants all to be drug sensitive.

No data was presented on subsequent patient treatment history.

Reference:

Koning FA et al. Dynamics of recombination in HIV-1 following superinfection described using single genome sequencing. 20th Intl Drug Resistance Workshop, 5–9 June 2012, Sitges. Abstract 62. Antiviral Therapy 2012: 17 Suppl 1:A77.