Quantitative deep sequencing reveals dynamic HIV-1 escape and large population shifts during CCR5 antagonist therapy in vivo

PLoS One. 2009 May 25;4(5):e5683. doi: 10.1371/journal.pone.0005683.

Abstract

High-throughput sequencing platforms provide an approach for detecting rare HIV-1 variants and documenting more fully quasispecies diversity. We applied this technology to the V3 loop-coding region of env in samples collected from 4 chronically HIV-infected subjects in whom CCR5 antagonist (vicriviroc [VVC]) therapy failed. Between 25,000-140,000 amplified sequences were obtained per sample. Profound baseline V3 loop sequence heterogeneity existed; predicted CXCR4-using populations were identified in a largely CCR5-using population. The V3 loop forms associated with subsequent virologic failure, either through CXCR4 use or the emergence of high-level VVC resistance, were present as minor variants at 0.8-2.8% of baseline samples. Extreme, rapid shifts in population frequencies toward these forms occurred, and deep sequencing provided a detailed view of the rapid evolutionary impact of VVC selection. Greater V3 diversity was observed post-selection. This previously unreported degree of V3 loop sequence diversity has implications for viral pathogenesis, vaccine design, and the optimal use of HIV-1 CCR5 antagonists.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Base Sequence
  • Biological Evolution
  • CCR5 Receptor Antagonists*
  • Entropy
  • HIV Infections / drug therapy*
  • HIV Infections / virology*
  • HIV-1 / drug effects*
  • HIV-1 / genetics
  • HIV-1 / physiology*
  • Humans
  • Likelihood Functions
  • Nucleic Acid Conformation
  • Piperazines / pharmacology*
  • Piperazines / therapeutic use
  • Pyrimidines / pharmacology*
  • Pyrimidines / therapeutic use
  • RNA, Viral / blood
  • RNA, Viral / chemistry
  • Reproducibility of Results
  • Selection, Genetic
  • Sequence Alignment
  • Sequence Analysis, DNA / methods*
  • Time Factors
  • Treatment Failure

Substances

  • CCR5 Receptor Antagonists
  • Piperazines
  • Pyrimidines
  • RNA, Viral
  • vicriviroc