Short communication: high polymorphism rates in the HR1 and HR2 gp41 and presence of primary resistance-related mutations in HIV type 1 circulating in Brazil: possible impact on enfuvirtide efficacy

AIDS Res Hum Retroviruses. 2010 Mar;26(3):307-11. doi: 10.1089/aid.2008.0297.

Abstract

We analyzed the gp41 sequences of 80 HIV-infected enfuvirtide-naive individuals who were eligible to receive this antiretroviral according to Brazilian guidelines. We analyzed the genetic diversity of pol and the heptad repeat 1 and 2 (HR1 and HR2) regions of gp41, and compared the genetic profile of HR1 and HR2 found in PBMCs with the profile found in plasma. The similarity between sequences obtained from DNA and RNA in the HR1 and HR2 regions was, on average, 98.6% and 98.9%, respectively. We detected mutations related to enfuvirtide resistance (L44M or N43K) in HR1 DNA samples from three individuals (3.8%) and RNA samples from three individuals (4.6%). Other polymorphisms frequently detected were E137K (10% and 13.8%), L130I (8.8% and 9.2%), S129N (6.3% and 10.8%), L44M (2.5% and 4.6%), S138A (2.5% and 1.5%), and N43K (1.3% and 0%) in DNA and RNA, respectively. Subtype B was identified in 68.8% of the samples [protease (PR) B, reverse transcriptase (RT) B, gp41 B], subtype F in 5.0%, subtype C in 1.3%, and the remaining sequences presented with a mosaic profile. These results suggest that genotyping the gp41 region prior to introducing an expensive and complex approach, such as enfuvirtide, may be cost effective. Moreover, assessment of proviral DNA may be less expensive than RNA, as well as being sufficient for this purpose.

MeSH terms

  • Adult
  • Brazil / epidemiology
  • DNA, Viral / analysis
  • DNA, Viral / blood
  • DNA, Viral / genetics
  • Drug Resistance, Viral / genetics*
  • Enfuvirtide
  • Genetic Variation
  • HIV Envelope Protein gp41 / genetics*
  • HIV Envelope Protein gp41 / therapeutic use
  • HIV Fusion Inhibitors / therapeutic use*
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / virology*
  • HIV-1 / drug effects
  • HIV-1 / genetics*
  • HIV-1 / metabolism
  • Humans
  • Leukocytes, Mononuclear / virology
  • Middle Aged
  • Peptide Fragments / therapeutic use*
  • Polymorphism, Single Nucleotide*
  • RNA, Viral / analysis
  • RNA, Viral / blood
  • RNA, Viral / genetics
  • Treatment Outcome
  • pol Gene Products, Human Immunodeficiency Virus / genetics

Substances

  • DNA, Viral
  • HIV Envelope Protein gp41
  • HIV Fusion Inhibitors
  • Peptide Fragments
  • RNA, Viral
  • pol Gene Products, Human Immunodeficiency Virus
  • Enfuvirtide