Resistance to the CCR5 Inhibitor 5P12-RANTES Requires a Difficult Evolution from CCR5 to CXCR4 Coreceptor Use
2011

Resistance to CCR5 Inhibitors in HIV-1: A Study on Coreceptor Switching

publication 10 minutes Evidence: moderate

Author Information

Author(s): Nedellec Rebecca, Coetzer Mia, Lederman Michael M., Offord Robin E., Hartley Oliver, Mosier Donald E.

Primary Institution: The Scripps Research Institute

Hypothesis

Can HIV-1 develop resistance to the CCR5 inhibitor 5P12-RANTES through coreceptor switching to CXCR4?

Conclusion

The study found that resistance to the CCR5 inhibitor 5P12-RANTES requires a more complex evolution involving coreceptor switching to CXCR4, compared to resistance to the small molecule inhibitor maraviroc.

Supporting Evidence

  • Resistance to maraviroc was achieved in 16-18 weeks with specific envelope mutations.
  • Only transient resistance to 5P12-RANTES was observed, leading to virus replication collapse.
  • Coreceptor switching to CXCR4 was necessary for sustained resistance to 5P12-RANTES.

Takeaway

HIV can change how it enters cells to avoid being stopped by medicines, and this change is harder to achieve with some medicines than others.

Methodology

The study involved in vitro selection experiments comparing the development of resistance to the small molecule inhibitor maraviroc and the macromolecular inhibitor 5P12-RANTES.

Limitations

The study was conducted in vitro, which may not fully replicate in vivo conditions.

Statistical Information

P-Value

p=0.0016

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pone.0022020

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