Human Immunodeficiency Virus Type 1 Quasi Species that Rebound After Discontinuation of Highly Active Antiretroviral Therapy are Similar to the Viral Quasi Species Present Before Initiation of Therapy [Imamichi H, et al. JID 2001;183:36]: The authors examined the HIV quasi species in three patients who had virologic rebound after discontinuation of HAART. All three had HIV RNA plasma levels <50 c/mL for one to three years. Sequences found in the rebound viruses were closely related to those that were present prior to HAART, and they were also present in proviral DNA, cell-associated RNA, and RNA obtained from PBMC obtained at times when there was no detectable virus in plasma. These findings indicate that virologic rebound with STI involves HIV strains from a relatively stable pool.
Comment: This study shows the lack of significant quasi-species evolution during HAART. The authors hypothesize that these observations support the concept of a reservoir of long-lived cells that chronically express low levels of virus so that the major effect of treatment is to protect uninfected CD4 cells. The possible cells of the reservoir may be the monocyte/macrophage cells, which resist the cytopathic effects of HIV.
posted 1/18/2001

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