Four patients had persistent viraemia during a trial of combivir/nevirapine therapy for HIV; 3 were from the group treated continuously and one from the strategic treatment interruption (STI) group (12 weeks off and 12 on from week 52 onwards). Samples were taken from these patients at weeks 72 and 120 and sequences of the viral protease-reverse transcriptase genes were determined and analysed phylogenetically. The conclusions were that: there was a delay in viral diversity in the STI group compared to the others; viral population diversity was correlated to viral load (but not at very high viral loads); the existence of resistance-related genetic diversity at both time points suggests a continual 'battle in the viral fitness landscape'; and more work is needed to fully understand the effect of treatment interuption on viral evolution in the host.
Kayondo, J.K.; Ndembi, N.; Cane, P.A.; Kityo, C.; Chirara, M.; Goodall, R.; Dunn, D.; Kaleebu, P.; Pillay, D.; Mbisa, J.L. Different evolution of resistance uncovered by single genome sequencing (SGS) analysis of patients with long term virological failure during continuous or interrupted therapy. Presented at International HIV and Hepatitis Virus Drug Resistance Workshop and Curative Strategies, Dubrovnik, Croatia, June 8-12 2010. (2010) [DOI: 10.3851/IMP1575]