151. Dolutegravir reshapes the genetic diversity of HIV-1 reservoirs
- Author
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Pierre Gantner, Christine Cheneau, Mahsa Mohseni-Zadeh, Marialuisa Partisani, Mark A. Wainberg, Geneviève Beck-Wirth, Jean-Pierre Faller, Martin Martinot, David Rey, Samira Fafi-Kremer, Guinevere Q. Lee, and Thibault Mesplède
- Subjects
0301 basic medicine ,Microbiology (medical) ,Adult ,Male ,Genotype ,Pyridones ,030106 microbiology ,HIV Infections ,Viral quasispecies ,HIV Integrase ,Biology ,V3 loop ,HIV Envelope Protein gp120 ,Piperazines ,03 medical and health sciences ,chemistry.chemical_compound ,Young Adult ,Genetic variation ,Oxazines ,Humans ,Pharmacology (medical) ,HIV Integrase Inhibitors ,Longitudinal Studies ,Prospective Studies ,Aged ,Pharmacology ,Genetic diversity ,Genetic Variation ,Sequence Analysis, DNA ,Middle Aged ,Virology ,Integrase ,Regimen ,030104 developmental biology ,Infectious Diseases ,Treatment Outcome ,chemistry ,Dolutegravir ,DNA, Viral ,biology.protein ,HIV-1 ,Female ,Heterocyclic Compounds, 3-Ring - Abstract
Objectives Better understanding of the dynamics of HIV reservoirs under ART is a critical step to achieve a functional HIV cure. Our objective was to assess the genetic diversity of archived HIV-1 DNA over 48 weeks in blood cells of individuals starting treatment with a dolutegravir-based regimen. Methods Eighty blood samples were prospectively and longitudinally collected from 20 individuals (NCT02557997) including: acutely (n = 5) and chronically (n = 5) infected treatment-naive individuals, as well as treatment-experienced individuals who switched to a dolutegravir-based regimen and were either virologically suppressed (n = 5) or had experienced treatment failure (n = 5). The integrase and V3 loop regions of HIV-1 DNA isolated from PBMCs were analysed by pyrosequencing at baseline and weeks 4, 24 and 48. HIV-1 genetic diversity was calculated using Shannon entropy. Results All individuals achieved or maintained viral suppression throughout the study. A low and stable genetic diversity of archived HIV quasispecies was observed in individuals starting treatment during acute infection. A dramatic reduction of the genetic diversity was observed at week 4 of treatment in the other individuals. In these patients and despite virological suppression, a recovery of the genetic diversity of the reservoirs was observed up to 48 weeks. Viral variants bearing dolutegravir resistance-associated substitutions at integrase position 50, 124, 230 or 263 were detected in five individuals (n = 5/20, 25%) from all groups except those who were ART-failing at baseline. None of these substitutions led to virological failure. Conclusions These data demonstrate that the genetic diversity of the HIV-1 reservoir is reshaped following the initiation of a dolutegravir-based regimen and strongly suggest that HIV-1 can continue to replicate despite successful treatment.
- Published
- 2017