Mutations related to antiretroviral resistance identified by ultra-deep sequencing in HIV-1 infected children under structured interruptions of HAART

Jose Manuel Vazquez-Guillen, Gerardo C. Palacios-Saucedo, Lydia G. Rivera-Morales, Jorge Garcia-Campos, Rocio Ortiz-Lopez, Marc Noguera-Julian, Roger Paredes, Herlinda J. Vielma-Ramirez, Teresa J. Ramirez, Marcelino Chavez-Garcia, Paulo Lopez-Guillen, Evangelina Briones-Lara, Luz M. Sanchez-Sanchez, Carlos A. Vazquez-Martinez, Cristina Rodriguez-Padilla

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    © 2016 Vazquez-Guillen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Although Structured Treatment Interruptions (STI) are currently not considered an alternative strategy for antiretroviral treatment, their true benefits and limitations have not been fully established. Some studies suggest the possibility of improving the quality of life of patients with this strategy; however, the information that has been obtained corresponds mostly to studies conducted in adults, with a lack of knowledge about its impact on children. Furthermore, mutations associated with antiretroviral resistance could be selected due to sub-therapeutic levels of HAART at each interruption period. Genotyping methods to determine the resistance profiles of the infecting viruses have become increasingly important for the management of patients under STI, thus low-abundance antiretroviral drug-resistant mutations (DRM’s) at levels under limit of detection of conventional genotyping (<20% of quasispecies) could increase the risk of virologic failure. In this work, we analyzed the protease and reverse transcriptase regions of the pol gene by ultra-deep sequencing in pediatric patients under STI with the aim of determining the presence of high- and low-abundance DRM’s in the viral rebounds generated by the STI. High-abundance mutations in protease and high- and low-abundance mutations in reverse transcriptase were detected but no one of these are directly associated with resistance to antiretroviral drugs. The results could suggest that the evaluated STI program is virologically safe, but strict and carefully planned studies, with greater numbers of patients and interruption/restart cycles, are still needed to evaluate the selection of DRM’s during STI.
    Original languageEnglish
    Article numbere0147591
    JournalPLoS ONE
    Issue number1
    Publication statusPublished - 1 Jan 2016


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