Exposure to MIV-150 from a high-dose intravaginal ring results in limited emergence of drug resistance mutations in SHIV-RT infected rhesus macaques.

When microbicides used for HIV prevention contain antiretroviral drugs, there is concern for the potential emergence of drug-resistant HIV following use in infected individuals who are either unaware of their HIV infection status or who are aware but still choose to use the microbicide. Resistant vi...

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Main Authors: Mayla Hsu, Brandon F Keele, Meropi Aravantinou, Noa Krawczyk, Samantha Seidor, Ciby J Abraham, Shimin Zhang, Aixa Rodriguez, Larisa Kizima, Nina Derby, Ninochka Jean-Pierre, Olga Mizenina, Agegnehu Gettie, Brooke Grasperge, James Blanchard, Michael J Piatak, Jeffrey D Lifson, José A Fernández-Romero, Thomas M Zydowsky, Melissa Robbiani
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0089300&type=printable
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author Mayla Hsu
Brandon F Keele
Meropi Aravantinou
Noa Krawczyk
Samantha Seidor
Ciby J Abraham
Shimin Zhang
Aixa Rodriguez
Larisa Kizima
Nina Derby
Ninochka Jean-Pierre
Olga Mizenina
Agegnehu Gettie
Brooke Grasperge
James Blanchard
Michael J Piatak
Jeffrey D Lifson
José A Fernández-Romero
Thomas M Zydowsky
Melissa Robbiani
author_facet Mayla Hsu
Brandon F Keele
Meropi Aravantinou
Noa Krawczyk
Samantha Seidor
Ciby J Abraham
Shimin Zhang
Aixa Rodriguez
Larisa Kizima
Nina Derby
Ninochka Jean-Pierre
Olga Mizenina
Agegnehu Gettie
Brooke Grasperge
James Blanchard
Michael J Piatak
Jeffrey D Lifson
José A Fernández-Romero
Thomas M Zydowsky
Melissa Robbiani
author_sort Mayla Hsu
collection DOAJ
description When microbicides used for HIV prevention contain antiretroviral drugs, there is concern for the potential emergence of drug-resistant HIV following use in infected individuals who are either unaware of their HIV infection status or who are aware but still choose to use the microbicide. Resistant virus could ultimately impact their responsiveness to treatment and/or result in subsequent transmission of drug-resistant virus. We tested whether drug resistance mutations (DRMs) would emerge in macaques infected with simian immunodeficiency virus expressing HIV reverse transcriptase (SHIV-RT) after sustained exposure to the potent non-nucleoside reverse transcriptase inhibitor (NNRTI) MIV-150 delivered via an intravaginal ring (IVR). We first treated 4 SHIV-RT-infected animals with daily intramuscular injections of MIV-150 over two 21 day (d) intervals separated by a 7 d drug hiatus. In all 4 animals, NNRTI DRMs (single and combinations) were detected within 14 d and expanded in proportion and diversity with time. Knowing that we could detect in vivo emergence of NNRTI DRMs in response to MIV-150, we then tested whether a high-dose MIV-150 IVR (loaded with >10 times the amount being used in a combination microbicide IVR in development) would select for resistance in 6 infected animals, modeling use of this prevention method by an HIV-infected woman. We previously demonstrated that this MIV-150 IVR provides significant protection against vaginal SHIV-RT challenge. Wearing the MIV-150 IVR for 56 d led to only 2 single DRMs in 2 of 6 animals (430 RT sequences analyzed total, 0.46%) from plasma and lymph nodes despite MIV-150 persisting in the plasma, vaginal fluids, and genital tissues. Only wild type virus sequences were detected in the genital tissues. These findings indicate a low probability for the emergence of DRMs after topical MIV-150 exposure and support the advancement of MIV-150-containing microbicides.
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institution Kabale University
issn 1932-6203
language English
publishDate 2014-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-b1f84d839f2a4832b1c088e64864c11d2025-08-20T03:46:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0192e8930010.1371/journal.pone.0089300Exposure to MIV-150 from a high-dose intravaginal ring results in limited emergence of drug resistance mutations in SHIV-RT infected rhesus macaques.Mayla HsuBrandon F KeeleMeropi AravantinouNoa KrawczykSamantha SeidorCiby J AbrahamShimin ZhangAixa RodriguezLarisa KizimaNina DerbyNinochka Jean-PierreOlga MizeninaAgegnehu GettieBrooke GraspergeJames BlanchardMichael J PiatakJeffrey D LifsonJosé A Fernández-RomeroThomas M ZydowskyMelissa RobbianiWhen microbicides used for HIV prevention contain antiretroviral drugs, there is concern for the potential emergence of drug-resistant HIV following use in infected individuals who are either unaware of their HIV infection status or who are aware but still choose to use the microbicide. Resistant virus could ultimately impact their responsiveness to treatment and/or result in subsequent transmission of drug-resistant virus. We tested whether drug resistance mutations (DRMs) would emerge in macaques infected with simian immunodeficiency virus expressing HIV reverse transcriptase (SHIV-RT) after sustained exposure to the potent non-nucleoside reverse transcriptase inhibitor (NNRTI) MIV-150 delivered via an intravaginal ring (IVR). We first treated 4 SHIV-RT-infected animals with daily intramuscular injections of MIV-150 over two 21 day (d) intervals separated by a 7 d drug hiatus. In all 4 animals, NNRTI DRMs (single and combinations) were detected within 14 d and expanded in proportion and diversity with time. Knowing that we could detect in vivo emergence of NNRTI DRMs in response to MIV-150, we then tested whether a high-dose MIV-150 IVR (loaded with >10 times the amount being used in a combination microbicide IVR in development) would select for resistance in 6 infected animals, modeling use of this prevention method by an HIV-infected woman. We previously demonstrated that this MIV-150 IVR provides significant protection against vaginal SHIV-RT challenge. Wearing the MIV-150 IVR for 56 d led to only 2 single DRMs in 2 of 6 animals (430 RT sequences analyzed total, 0.46%) from plasma and lymph nodes despite MIV-150 persisting in the plasma, vaginal fluids, and genital tissues. Only wild type virus sequences were detected in the genital tissues. These findings indicate a low probability for the emergence of DRMs after topical MIV-150 exposure and support the advancement of MIV-150-containing microbicides.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0089300&type=printable
spellingShingle Mayla Hsu
Brandon F Keele
Meropi Aravantinou
Noa Krawczyk
Samantha Seidor
Ciby J Abraham
Shimin Zhang
Aixa Rodriguez
Larisa Kizima
Nina Derby
Ninochka Jean-Pierre
Olga Mizenina
Agegnehu Gettie
Brooke Grasperge
James Blanchard
Michael J Piatak
Jeffrey D Lifson
José A Fernández-Romero
Thomas M Zydowsky
Melissa Robbiani
Exposure to MIV-150 from a high-dose intravaginal ring results in limited emergence of drug resistance mutations in SHIV-RT infected rhesus macaques.
PLoS ONE
title Exposure to MIV-150 from a high-dose intravaginal ring results in limited emergence of drug resistance mutations in SHIV-RT infected rhesus macaques.
title_full Exposure to MIV-150 from a high-dose intravaginal ring results in limited emergence of drug resistance mutations in SHIV-RT infected rhesus macaques.
title_fullStr Exposure to MIV-150 from a high-dose intravaginal ring results in limited emergence of drug resistance mutations in SHIV-RT infected rhesus macaques.
title_full_unstemmed Exposure to MIV-150 from a high-dose intravaginal ring results in limited emergence of drug resistance mutations in SHIV-RT infected rhesus macaques.
title_short Exposure to MIV-150 from a high-dose intravaginal ring results in limited emergence of drug resistance mutations in SHIV-RT infected rhesus macaques.
title_sort exposure to miv 150 from a high dose intravaginal ring results in limited emergence of drug resistance mutations in shiv rt infected rhesus macaques
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0089300&type=printable
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