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Molecular mechanisms of HIV type 1 prophylaxis failure revealed by single-genome sequencing.


ABSTRACT: Trials of human immunodeficiency virus type 1 (HIV) pre- and postexposure prophylaxis show promise. Here, we describe a novel strategy for deciphering mechanisms of prophylaxis failure that could improve therapeutic outcomes. A healthcare worker began antiretroviral prophylaxis immediately after a high-risk needlestick injury but nonetheless became viremic 11 weeks later. Single-genome sequencing of plasma viral RNA identified 15 drug susceptible transmitted/founder HIV genomes responsible for productive infection. Sequences emanating from these genomes exhibited extremely low diversity, suggesting virus sequestration as opposed to low-level replication as the cause of breakthrough infection. Identification of transmitted/founder viruses allows for genome-wide assessment of molecular mechanisms of prophylaxis failure.

SUBMITTER: Li H 

PROVIDER: S-EPMC3805246 | biostudies-other | 2013 Nov

REPOSITORIES: biostudies-other

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Molecular mechanisms of HIV type 1 prophylaxis failure revealed by single-genome sequencing.

Li Hui H   Blair Lily L   Chen Yalu Y   Learn Gerald G   Pfafferott Katja K   John Mina M   Bhattacharya Tanmoy T   Hahn Beatrice H BH   Mallal Simon S   Shaw George M GM   Bar Katharine J KJ  

The Journal of infectious diseases 20130909 10


Trials of human immunodeficiency virus type 1 (HIV) pre- and postexposure prophylaxis show promise. Here, we describe a novel strategy for deciphering mechanisms of prophylaxis failure that could improve therapeutic outcomes. A healthcare worker began antiretroviral prophylaxis immediately after a high-risk needlestick injury but nonetheless became viremic 11 weeks later. Single-genome sequencing of plasma viral RNA identified 15 drug susceptible transmitted/founder HIV genomes responsible for p  ...[more]

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