Prevalence of CXCR4 Tropism among Antiretroviral-Treated HIV-1--Infected Patients with Detectable Viremia

Hunt, Peter W.; Harrigan, P. Richard; Huang, Wei; Bates, Michael; Williamson, David W.; McCune, Joseph M.; Price, Richard W.; Spudich, Serena S.; Lampiris, Harry; Hoh, Rebecca; Leigler, Teri; Martin, Jeffrey N.; Deeks, Steven G.
October 2006
Journal of Infectious Diseases;10/1/2006, Vol. 194 Issue 7, p926
Academic Journal
Although CXCR4-tropic viruses are relatively uncommon among untreated human immunodeficiency virus (HIV)-infected individuals except during advanced immunodeficiency, the prevalence of CXCR4-tropic viruses among treated patients with detectable viremia is unknown. To address this issue, viral coreceptor usage was measured with a single-cycle recombinant-virus phenotypic entry assay in treatment-naive and treated HIV-infected participants with detectable viremia sampled from 2 clinic-based cohorts. Of 182 treated participants, 75 (41%) harbored dual/mixed or X4-tropic viruses, compared with 178 (18%) of the 976 treatment-naive participants (P<.001). This difference remained significant after adjustment for CD4+ T cell count and CCR5 Δ32 genotype. Enrichment for dual/mixed/X4-tropic viruses among treated participants was largely but incompletely explained by lower pretreatment nadir CD4 + T cell counts. CCR5 inhibitors may thus be best strategically used before salvage therapy and before significant CD4 + T cell depletion.


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