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    Most studies about HIV-1 molecular evolution have shown the lack of viral evolution on effective antiretroviral therapy (ART), although controversial results have been documented. We therefore aimed to look for evidence of HIV-1 evolution in patients who initiated ART at the time of primary HIV-1 infection (PHI). We included retrospectively 20 patients diagnosed at PHI, treated at the time of acute infection and with subsequent effective long-term suppressive ART (HIV viral load <20 copies/ml during at least 5 years without any blips). Longitudinal blood samples were deep sequenced using Illumina Miseq. Drug-resistance-associated mutations were retained at 2% cutoff and interpreted using the latest Agence Nationale de Recherches sur le Sida et les Hépatites Virales resistance algorithm. Viral evolution was established when temporal structure on maximum-likelihood phylogenetic tree and significant change over time of HIV-1 genetic diversity measured as the average pairwise distance was observed. Emergences or disappearances of drug-resistance-associated mutations were detected in the blood cells during follow-up despite sustained virological control. In all patients, tree topologies showed an absence of segregation between sequences and blood viral populations from all time-points were intermingled. Comparison of the average pairwise distance showed the absence of significant viral diversity at the time of primary infection and afterwards during 5 years of full virological control under ART. Despite a slight variation of minority resistance-associated mutation variants, there was no clear evidence of viral evolution during a prolonged period of time in this population of highly controlled adult patients treated at time of PHI.


    Basma Abdi, Thuy Nguyen, Sophie Brouillet, Nathalie Desire, Sophie Sayon, Marc Wirden, Aude Jary, Guillaume Achaz, Lambert Assoumou, Romain Palich, Anne Simon, Roland Tubiana, Marc-Antoine Valantin, Christine Katlama, Vincent Calvez, Anne-Geneviève Marcelin, Cathia Soulie. No HIV-1 molecular evolution on long-term antiretroviral therapy initiated during primary HIV-1 infection. AIDS (London, England). 2020 Oct 01;34(12):1745-1753

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    PMID: 32694418

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