HIV-1 clinical isolates resistant to CCR5 antagonists exhibit delayed entry kinetics that are corrected in the presence of drug.

TitleHIV-1 clinical isolates resistant to CCR5 antagonists exhibit delayed entry kinetics that are corrected in the presence of drug.
Publication TypeJournal Article
Year of Publication2012
AuthorsPutcharoen O, Lee SHee, Henrich TJ, Hu Z, Vanichanan J, Coakley E, Greaves W, Gulick RM, Kuritzkes DR, Tsibris AMN
JournalJ Virol
Volume86
Issue2
Pagination1119-28
Date Published2012 Jan
ISSN1098-5514
KeywordsAmides, Anti-HIV Agents, CCR5 Receptor Antagonists, Drug Resistance, Viral, HIV Envelope Protein gp120, HIV Infections, HIV-1, Humans, Kinetics, Molecular Sequence Data, Mutation, Piperazines, Pyrimidines, Quaternary Ammonium Compounds, Virus Internalization
Abstract

HIV CCR5 antagonists select for env gene mutations that enable virus entry via drug-bound coreceptor. To investigate the mechanisms responsible for viral adaptation to drug-bound coreceptor-mediated entry, we studied viral isolates from three participants who developed CCR5 antagonist resistance during treatment with vicriviroc (VCV), an investigational small-molecule CCR5 antagonist. VCV-sensitive and -resistant viruses were isolated from one HIV subtype C- and two subtype B-infected participants; VCV-resistant isolates had mutations in the V3 loop of gp120 and were cross-resistant to TAK-779, an investigational antagonist, and maraviroc (MVC). All three resistant isolates contained a 306P mutation but had variable mutations elsewhere in the V3 stem. We used a virus-cell β-lactamase (BlaM) fusion assay to determine the entry kinetics of recombinant viruses that incorporated full-length VCV-sensitive and -resistant envelopes. VCV-resistant isolates exhibited delayed entry rates in the absence of drug, relative to pretherapy VCV-sensitive isolates. The addition of drug corrected these delays. These findings were generalizable across target cell types with a range of CD4 and CCR5 surface densities and were observed when either population-derived or clonal envelopes were used to construct recombinant viruses. V3 loop mutations alone were sufficient to restore virus entry in the presence of drug, and the accumulation of V3 mutations during VCV therapy led to progressively higher rates of viral entry. We propose that the restoration of pre-CCR5 antagonist therapy HIV entry kinetics drives the selection of V3 loop mutations and may represent a common mechanism that underlies the emergence of CCR5 antagonist resistance.

DOI10.1128/JVI.06421-11
Alternate JournalJ. Virol.
PubMed ID22090117
PubMed Central IDPMC3255837
Grant ListAI051966 / AI / NIAID NIH HHS / United States
AI055357 / AI / NIAID NIH HHS / United States
AI068636 / AI / NIAID NIH HHS / United States
AI069419 / AI / NIAID NIH HHS / United States
K24 AI051966 / AI / NIAID NIH HHS / United States
P30 AI060354 / AI / NIAID NIH HHS / United States
R37 AI055357 / AI / NIAID NIH HHS / United States
RR016482 / RR / NCRR NIH HHS / United States
RR024996 / RR / NCRR NIH HHS / United States
T32 AI007387 / AI / NIAID NIH HHS / United States
UL1 RR025758 / RR / NCRR NIH HHS / United States
UL1 RR025758 / RR / NCRR NIH HHS / United States