HIV-1 DNA drug resistance testing to guide successful suppression of low-level viraemia: a case report

A treatment-naïve 10-year-old female patient living with HIV-1 infection started antiretroviral therapy (ART) in April 2018 with zidovudine+lamivudine+nevirapine, which was changed 19 months later to zidovudine+lamivudine+efavirenz. The HIV-1 RNA load ranged between 55 and 420 copies/mL between February 2020 and May 2021, and was 485 copies/mL in January 2022. At this time, the total HIV-1 DNA load in peripheral blood was 2260 copies/million white blood cells (WBCs) as measured with a HIV-1 DNA quantification kit (Supbio, Guangzhou, China). Genotypic drug resistance testing (pol region amplification and Sanger sequencing) failed when using plasma due to the low viral load. However, Sanger sequencing of HIV-1 DNA pol region revealed the drug resistance-associated mutations (DRMs) M184V for the nucleoside reverse transcriptase inhibitors (NRTIs) and K101P and K103N for the non-nucleoside reverse transcriptase inhibitors (NNRTIs). This corresponded to high-level resistance to emtricitabine, lamivudine, efavirenz, etravirine, nevirapine and rilpivirine; low-level resistance to abacavir; and...
Source: Sexually Transmitted Infections - Category: Sexual Medicine Authors: Tags: PostScript Source Type: research