Variants minoritaires du VIH-1 : détection, quantification et implications cliniques

Area of Science:

• Virology
• Infectious Diseases
• Pharmacogenomics

Background:

• Antiretroviral therapy (ART) success for HIV is challenged by drug-resistant variants.
• Conventional assays often miss low-level resistant variants, impacting treatment efficacy.
• High-throughput sequencing (HTS) enables sensitive detection and quantification of minority variants.

Purpose of the Study:

• To investigate the clinical significance of detecting minority drug-resistant variants in HIV.
• To determine if minority variants influence treatment response to specific antiretroviral drug classes.

Main Methods:

• Utilized high-throughput sequencing to detect and quantify minority variants (<20%) in HIV viral populations.
• Correlated the presence of specific minority variants with virological treatment outcomes.

Main Results:

• Detection of minority variants resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs) is linked to increased virological failure risk in patients on NNRTI-based ART.
• Detection of minority X4-using variants is associated with a higher risk of virological failure in patients receiving CCR5 antagonists.
• No similar association was observed for other antiretroviral drug classes.

Conclusions:

• Minority variant detection may aid in optimizing NNRTI and CCR5 antagonist-containing HIV treatments.
• Prospective studies are needed to confirm these associations and refine treatment strategies.
• HTS offers a valuable tool for identifying low-level resistance and guiding personalized HIV therapy.