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JAC Advance Access originally published online on February 22, 2005
Journal of Antimicrobial Chemotherapy 2005 55(4):410-412; doi:10.1093/jac/dki038
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions{at}oupjournals.org

Leading article

The latent HIV-1 reservoir in patients undergoing HAART: an archive of pre-HAART drug resistance

Ann Noë, Jean Plum and Chris Verhofstede*

AIDS Reference Laboratory, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium

* Corresponding author. Tel: +32-9-240-51-61; Fax: +32-9-240-36-59; Email: chris.verhofstede{at}ugent.be

Recent studies on patients with a history of pre-HAART drug resistance, but currently on a successful regimen, provided new insights into the dynamics of the latent cellular viral reservoir. Results indicated that the latent reservoir is an archive, composed of a mixture of wild-type and drug-resistant strains. The studies showed that, even after years of successful HAART, the wild-type viral strains that circulated before the initiation of the therapy as well as all the different drug-resistant viral strains that evolved over time during eventual periods of non-suppressive treatment, remain detectable in the proviral reservoir. These findings support the hypothesis that during active viral replication, new variants, including drug-resistant ones, continuously enter the latent viral reservoir. It can be concluded that, as a consequence of the lifelong conservation of this latent reservoir, the potency of drugs for which resistance once developed will remain reduced, even after years of withdrawal of the drug.

Keywords: reservoirs of resistance , mechanisms of resistance , mutations


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