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Combination Antiretroviral Therapy (cART) and Cell-cell spread of Wild-type and Drug-Resistant HIV-1

Titanji, BK; Pillay, D; Jolly, C; (2017) Combination Antiretroviral Therapy (cART) and Cell-cell spread of Wild-type and Drug-Resistant HIV-1. Journal of General Virology , 98 pp. 821-834. 10.1099/jgv.0.000728. Green open access

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Abstract

HIV-1 disseminates between T cells either by cell-free infection or by highly-efficient direct cell-cell spread. The high local multiplicity that characterizes cell-cell infection causes variability in the effectiveness of antiretroviral drugs applied as single agents. Whereas Protease Inhibitors (PIs) are effective inhibitors of HIV-1 cell-cell and cell-free infection, some Reverse Transcriptase Inhibitors (RTIs) show reduced potency; however antiretrovirals are not administered as single agents and are clinically used as combination antiretroviral therapy (cART). Here we explored the efficacy of PI and RTI-based cART against cell-cell spread of wild-type and drug-resistant HIV-1 strains. Using a quantitative assay to measure cell-cell spread of HIV-1 between T cells, we evaluated the efficacy of different clinically relevant drug combinations. We show that combining PIs and RTIs improves the potency of inhibition of HIV-1 and effectively blocks both cell-free and cell-cell spread. Combining drugs that alone are poor inhibitors of cell-cell spread markedly improves HIV-1 inhibition, demonstrating that clinically relevant combinations of ART can inhibit this mode of HIV-1 spread. Furthermore, comparison of WT and drug-resistant viruses reveals that PI and RTI resistant viruses have a replicative advantage over wild-type virus when spreading by cell-cell means in the presence of cART, suggesting that in the context of inadequate drug combinations or drug resistance, cell-cell spread could potentially allow for ongoing viral replication.

Type: Article
Title: Combination Antiretroviral Therapy (cART) and Cell-cell spread of Wild-type and Drug-Resistant HIV-1
Open access status: An open access version is available from UCL Discovery
DOI: 10.1099/jgv.0.000728
Publisher version: http://dx.doi.org/10.1099/jgv.0.000728
Language: English
Additional information: This is an open access article published by the Microbiology Society under the Creative Commons Attribution License
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
URI: https://discovery.ucl.ac.uk/id/eprint/1540040
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