The mechanisms of human immunodeficiency virus (HIV) infection of a man (VH) homozygous for the CCR5Delta32 mutation were investigated, and coreceptors other than CCR5 used by HIV type 1 (HIV-1) isolated from this individual were identified. In contrast to previous reports, this individual's rate of disease progression was not accelerated. Homozygosity for CCR5Delta32 mutation was demonstrated by PCR and DNA sequencing (R. Biti et al., Nat. Med. 3:252-253, 1997). CCR5 surface expression was absent on T lymphocytes and macrophages. HIV was isolated by coculture with peripheral blood mononuclear cells (PBMCs) from siblings who were homozygous (VM) or wild type (WT) for the CCR5Delta32 mutation. The virus demonstrated dual tropism for infection of MT2 cell line and primary macrophages. Sequencing of the full HIV genome directly from the patient's PBMCs revealed 21 nucleotide insertions in the V1 region of gp120. The VH envelope sequence segregated apart from both the T-cell-line-adapted tropic strains NL4-3 and SF2 and M-tropic strain JRFL or YU2 by phylogenetic tree analysis. VH was shown to utilize predominantly CXCR4 for entry into T lymphocytes and macrophages by HOS.CD4 cell infection assay, direct envelope protein fusion, and inhibition by anti-CXCR4 monoclonal antibody (12G5), SDF-1, and AMD3100. Microsatellite mapping demonstrated the separate inheritance of CXCR4 by both homozygote brothers (VH and VM). Our study demonstrates the ability of certain strains of HIV to readily use CXCR4 for infection or entry into macrophages, which is highly relevant to the pathogenesis of late-stage disease and presumably also HIV transmission.
Herpes simplex type 1 (HSV-1) and type 2 (HSV-2), varicella-zoster virus (VZV) and human cytomegalovirus (CMV) cause diseases that are usually self-limiting in the immunocompetent host. However, HSV-1, HSV-2, VZV, and CMV are major causes of morbidity and mortality in the immunocompromised patient. Prolonged antiviral treatment is often required for the clinical management of herpesvirus infections in the immunocompromised patient, and this favors the emergence of drug-resistant strains. The isolation of acyclovir-resistant (ACV(r)) HSV-1, HSV-2, and VZV strains as well as ganciclovir-resistant (GCV(r)) CMV strains has been reported with increasing frequency and is a major concern (1-3). Resistance to foscarnet (phosphonoformic acid [PFA]), the drug of choice when ACV or GCV fails, has also been described in the clinic (4,5). Furthermore, double resistance to both GCV and PFA (for CMV) and to both ACV and PFA (for HSV) has been observed in immuno-compromised patients after sequential and concomitant treatment with either or both drugs.
This new volume of Advances in Pharmacology explores the current state of antiviral agents. Chapters cover such topics as virus entry inhibitors, interferon-free drug combinations, and antiviral agents for HSV. With a variety of chapters and the best authors in the field, the volume is an essential resource for pharmacologists, immunologists and biochemists alike. Explores the current state of anti-viral agents Chapters cover a variety of topics such as virus entry inhibitors, interferon-free drug combinations, and antiviral agents for HSV With the best authors in the field, the volume is an essential resource for pharmacologists, immunologists and biochemists alike