Antiretroviral drug-resistant HIV-2 infection - a new therapeutic dilemma

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Antiretroviral drug-resistant HIV-2 infection - a new therapeutic

dilemma

Authors: Maniar, Janak K.1; Damond, Florence2; Kamath, Ratnakar R.3;

Mandalia, Sundhiya4; Surjushe, Amar5

Source: International Journal of STD & AIDS, Volume 17, Number 11,

November 2006, pp. 781-782(2)

Abstract:

HIV-2 drug resistance in a case of dual HIV infection presents a

formidable challenge to the treating physician. We report a patient

with dual infection on highly active antiretroviral therapy (HAART)

since March 2001 presented with clinical failure. Laboratory assays

showed undetectable HIV-1 viral RNA copies, but with low CD4 count.

Suspecting HIV-2 resistance, specific genotype assays were

performed. Mutations at codons M184V and Q151M conferring resistance

to nucleoside reverse transcriptase inhibitors (NRTIs) in HIV-1

infection were detected, as were mutations at codons V71I and L90M

implying indinavir and nelfinavir resistance as well. Salvage

therapy was initiated with good clinical response.

Keywords: HIV-2; DRUG RESISTANCE; DUAL INFECTION

Document Type: Case report

DOI: 10.1258/095646206778691059

Affiliations: 1: Department of Infectious Diseases, Jaslok Hospital

& Research Centre, Mumbai, Maharashtra, India 2: Laboratoire de

Virologie, Hôpital Bichat Claude Bernard, Paris, France 3:

Foundation for Medical Research, Worli, Mumbai, Maharashtra, India

4: Department of Medicine, Imperial College London, Chelsea and

Westminster, Hospital London, UK 5: The Salvation Army, Mumbai

HIV/AIDS Community Development Programme, Mumbai, Maharashtra, India