Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0006849 (oral candidiasis)
 1,939 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Development of a drug-resistant variant of HIV-1 has been one of the major concerns contributing to the transmission of the virus. A 40-year-old woman presented to the clinic with micosis and oral candidiasis. The subject was referred for HIV-1 diagnosis. Subsequent investigations revealed a very low CD4 T cell count (48 cell/microl blood) and high plasma HIV-1 RNA load (4.33 x 10(5) copy/ml). A 1.3-kb pol fragment was sequenced in virus collected from plasma and the vaginal compartment. Plasma virus had no mutation in reverse transcriptase and one mutation in protease (L63P). On the other hand vaginal virus contained L63P and M184V mutations in protease and reverse transcriptase, respectively. These mutations were accompanied by several other mutations in previously identified CTL epitopic regions of the two genes. In the absence of antiretroviral treatment, a drug-resistant mutant was thought to develop because of immune pressure. This is the first report describing the role of immune pressure in the development of a drug-resistant virus.
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PMID:Compartmentalization of drug resistance-associated mutations in a treatment-naive HIV-infected female. 1524 47

A major proportion of the global HIV infections is caused by group M of HIV-1 genotype and to date approximately nine subtypes (A, B, C, D, F, G, H, J, K) and 50 circulating recombinant forms (CRFs) have been recognized. Recombinants between different HIV-1 group M subtypes are designated as CRF. The extension 'cpx', for complex, is given if the CRF consists of contributions from three or more different subtypes but the composition of the subtype is not given. The objective of this study was to present, for the first time an HIV-1 positive married couple infected with CRF06_cpx subtype in Izmir, Turkey. A 39-year-old male patient who admitted to hospital with the complaints of oral candidiasis and zona, was found to be anti-HIV positive. CD4+ T lymphocyte count was 21 cells/mm3 and plasma HIV-1 RNA level was 56.380 copies/ml. He reported unprotected heterosexual contact with multiple partners including African women during his stay in Saudi Arabia between 1996 and 2002. After his diagnosis, his 37-year-old wife was screened for HIV infection and she was also found anti-HIV positive, with CD4+ T cell count of 122 cells/mm3. However, her results of basal plasma HIV-1 RNA could not be obtained because of an internal control error. HIV-1 strains were analysed for subtyping, recombination and drug resistance mutations with pol gene region sequencing. HIV-1 sequences were subtyped as CRF06_cpx after phylogenetic analysis using neighbor-joining method. According to the recombination analysis, HIV-1 pol gene regions consisted of group M subtype G, A, D, and B in the male patient and G K, A, F, and D in the female patient. While L10I + L33F mutation associated with protease inhibitor (PI) resistance was detected in both of the patients, K219N mutation associated with nucleoside reverse transcriptase inhibitor (NRTI) resistance was detected only in the male patient. In conclusion, HIV-1 molecular epidemiology studies are important tools for tracking transmission patterns and the spread of CRF. Global monitoring of CRF subtypes is also important to supply data for HIV vaccine development studies. On the other hand, the detection of HIV-1 primary resistance mutations in antiretroviral naive patients suggested that the resistance testing should be an integral part of the management of HIV infection.
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PMID:[Molecular characterization of complex recombinant HIV-1 CRF06_cpx subtype detected in Turkey]. 2450 27