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Journal of Clinical Microbiology, July 2009, p. 2200-2208, Vol. 47, No. 7
0095-1137/09/$08.00+0     doi:10.1128/JCM.01654-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Virological Response to Highly Active Antiretroviral Therapy in Patients Infected with Human Immunodeficiency Virus Type 2 (HIV-2) and in Patients Dually Infected with HIV-1 and HIV-2 in The Gambia and Emergence of Drug-Resistant Variants{triangledown}

Sabelle Jallow,1,2* Abraham Alabi,1 Ramu Sarge-Njie,1 Kevin Peterson,1 Hilton Whittle,1 Tumani Corrah,1 Assan Jaye,1 Matthew Cotten,1 Guido Vanham,2,3 Samuel J. McConkey,1,{dagger} Sarah Rowland-Jones,1,4 and Wouter Janssens2

Medical Research Council Laboratories (MRC), Banjul, The Gambia,1 Department of Microbiology, Institute of Tropical Medicine,2 Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium,3 Weatherall Institute of Molecular Medicine, Medical Research Council, Human Immunology Unit, John Radcliffe Hospital, Oxford, United Kingdom4

Received 26 August 2008/ Returned for modification 17 January 2009/ Accepted 7 April 2009

Drug design, antiretroviral therapy (ART), and drug resistance studies have focused almost exclusively on human immunodeficiency virus type 1 (HIV-1), resulting in limited information for patients infected with HIV-2 and for those dually infected with HIV-1 and HIV-2. In this study, 20 patients, 12 infected with HIV-2 and 8 dually infected with HIV-1 and HIV-2, all treated with zidovudine (ZDV), lamivudine (3TC), and lopinavir-ritonavir (LPV/r), were followed up longitudinally for about 3 years. For 19/20 patients, viral loads were reduced to undetectable levels; the patient whose viral load remained detectable reported adverse effects associated with LPV/r that had caused him to stop taking all the drugs. HIV-2 strains containing mutations in both the protease and the reverse transcriptase gene that may confer drug resistance were observed in two patients with viral rebound, as early as 130 days (4.3 months) after the initiation of therapy. We conclude that the combination of ZDV, 3TC, and LPV/r is able to provide efficient and durable suppression of HIV-1 and HIV-2 for as long as 3 years in HIV-2-infected and dually infected patients. However, the emergence of HIV-1 and HIV-2 strains containing drug-resistant mutations can compromise the efficacy of this highly active ART.

* Corresponding author. Mailing address: Medical Research Council Laboratories, Viral Disease Program, P.O. Box 273, Fajara, The Gambia. Phone: 220 4495 442, ext. 2902. Fax: 220 4496 513. E-mail: sabelle.jallow{at}ndm.ox.ac.uk

{triangledown} Published ahead of print on 6 May 2009.

{dagger} Present address: Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.

Journal of Clinical Microbiology, July 2009, p. 2200-2208, Vol. 47, No. 7
0095-1137/09/$08.00+0     doi:10.1128/JCM.01654-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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