Minority K65R Variants and Early Failure of Antiretroviral Therapy in HIV-1–infected Eritrean Immigrant

摘要

To the Editor: Genotypic drug resistance testing before initiation of fi rst-line antiretroviral therapy (ART) is recommended to detect drug-resistant viruses and to avoid treatment failure caused by preexisting drug-resistant viruses (1). However, standard resistance testing cannot detect drug-resistant HIV-1 minority variants unless they represent 20%–25% of the population (2). Approximately 15% of those who underwent seroconversion in the acute phase in industrialized settings harbor drug-resistant HIV-1 minority variants, while standard resistance testing did not detect drug-resistant viruses in those patients (3). We report the case of a treatment-naive HIV-1–infected patient with early treatment failure because of preexisting minority K65R-harboring HIV-1 variants