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Question :

Posted On : 25 Feb 2009

I hav a 8yr old child on 2nd line HAART for HIV. He seems to be still failing therapy. I recently got his HIV typing assay which shows that he has HIV type O virus . in my region we mainly deal with type C HIV. I dont know if anyone has any literature pertaining to susceptibility of Type O virus is it the same as type C or do I need to change therapy

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Answer Discussion :

pediatriconcall

Answer :
The strains of HIV-1 can be classified into three groups: the major group M, the outlier group O and the new group N. Group O appears to be restricted to west-central Africa and group N - discovered in 1998 in Cameroon - is extremely rare. Within group M there are known to be at least nine genetically distinct subtypes {or clades} of HIV-1. These are subtypes A, B, C, D, F, G, H, J and K. More than 90percent of HIV-1 infections belong to HIV-1 group M. Resistance testing has been standardised for Subtype B. Its diagnostic efficacy is sub type O will not be upto the mark. HIV Type O is associated with reduced replicative and transmission fitness and hence is rare. In vitro data showed that HIV-1 group O viruses are naturally resistant to nonnucleoside reverse transcriptase inhibitors, as is HIV-2. Group O isolates were highly sensitive to nucleoside inhibitors. Differences in susceptibility to saquinavir and ritonavir {RTV} were not significant between group O and group M isolates, although the 50percent inhibitory concentration of RTV for group O isolates was higher than that for the HIV-1 subtype B strains.

16 years ago

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