HIV-1 drug resistance in variants from the female genital tract and plasma

Kimdar Sherefa Kemal, Harold Burger, Douglas Mayers, Kathryn Anastos, Brian Foley, Christina Kitchen, Penelope Huggins, Tamara Schroeder, Gaston Picchio, Sara Back, Wei Gao, William A. Meyer, Barbara Weiser

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Background. Human immunodeficiency virus type 1 (HIV-1) drug-resistance mutations may arise in a fraction of viral variants, and these variants may differ between compartments, including the genital tract and blood. Methods. We studied 14 women with detectable HIV-1 in both the genital tract and plasma despite antiretroviral treatment. We obtained HIV-1 RNA sequences from 280 unique viral variants and then determined the resistance genotype and the predicted phenotype (Virtual Phenotype; Virco BVBA) of each variant. Results. Eight patients (57%) displayed mutations conferring high-level HIV-1 drug resistance. Although we observed differences in specific mutations among viral variants, 13 of the 14 women showed highly concordant HIV-1 genotypic and predicted phenotypic resistance patterns in the 2 compartments. In 1 patient, resistance mutations appeared only in plasma; all variants in her genital tract, which displayed a low viral load, were susceptible. Conclusions. These data suggest that, for the majority of women, determination of HIV-1 drug resistance in the plasma will approximate the drug-resistance pattern in the genital tract. Analysis of individual variants enabled us to identify minority species bearing distinctive linked mutations, which may serve as a source of novel resistance genotypes. These data are relevant to clinical management and the evolution of drug resistance.

Original languageEnglish (US)
Pages (from-to)535-545
Number of pages11
JournalJournal of Infectious Diseases
Issue number4
StatePublished - Feb 15 2007

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases


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