Infection with multidrug resistant, dual-tropic HIV-1 and rapid progression to AIDS: a case report.
Infection with multidrug resistant, dual-tropic HIV-1 and rapid progression to AIDS: a case report.
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多重耐药性、双向性 HIV-1 感染和快速进展为艾滋病：病例报告。
DOI：
10.1016/s0140-6736(05)71139-9
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发表时间：
2005
期刊：
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作者：
Markowitz,Martin;Mohri,Hiroshi;Mehandru,Saurabh;Shet,Anita;Berry,Leslie;Kalyanaraman,Roopa;Kim,Alexandria;Chung,Chris;Jean-Pierre,Patrick;Horowitz,Amir;LaMar,Melissa;Wrin,Terri;Parkin,Neil;Poles,Michael;Petropoulos,Christos;
背景急性HIV-1感染后迅速进展为AIDS，虽然不常见，但已被注意到，正如多药耐药病毒的传播一样。在这里，我们描述了一个病人，这两个因素同时出现，并评估effects.MethodsWe做了一个病例研究的HIV-1血清转换的患者。我们通过PCR和核苷酸测序对病毒和宿主遗传标记进行基因分型。为了确定我们患者的HIV-1的药物敏感性，我们用PhenoSense测定法进行了表型研究。我们通过体外合胞体的形成，并与一个修改的PhenoSense assay.FindingsOur病人最近似乎已经感染了HIV-1的病毒变异耐多类抗逆转录病毒药物，评估了病毒辅助受体的使用。此外，他的病毒群体对表达CCR 5或CXCR 4辅助受体的细胞具有双重嗜性。该感染已导致在4-20 months.InterpretationThe交叉的多药耐药性和艾滋病的快速发展，在这个病人是令人关注的，特别是在考虑到他的病史，其中包括高风险的性接触和使用metamfetamine。这种情况对公众健康的影响是巨大的。
BackgroundRapid progression to AIDS after acute HIV-1 infection, though uncommon, has been noted, as has the transmission of multidrug resistant viruses. Here, we describe a patient in whom these two factors arose concomitantly and assess the effects.MethodsWe did a case study of a patient with HIV-1 seroconversion. We genotyped the virus and host genetic markers by PCR and nucleotide sequencing. To ascertain the drug susceptibility of our patient's HIV-1 we did phenotypic studies with the PhenoSense assay. We assessed viral coreceptor use via syncytium formation in vitro and with a modified PhenoSense assay.FindingsOur patient seems to have been recently infected by a viral variant of HIV-1 resistant to multiple classes of antiretroviral drugs. Furthermore, his virus population is dual tropic for cells that express CCR5 or CXCR4 coreceptor. The infection has resulted in progression to symptomatic AIDS in 4–20 months.InterpretationThe intersection of multidrug resistance and rapid development of AIDS in this patient is of concern, especially in view of his case history, which includes high-risk sexual contacts and use of metamfetamine. The public health ramifications of such a case are great.