HIV-2 integrase gene polymorphism and phenotypic susceptibility of HIV-2 clinical isolates to the integrase inhibitors raltegravir and elvitegravir in vitro

J Antimicrob Chemother. 2008 Nov;62(5):914-20. doi: 10.1093/jac/dkn335. Epub 2008 Aug 20.

Abstract

Objectives: We investigated the in vitro phenotypic susceptibility of HIV-2 isolates from integrase inhibitor (INI)-naive patients to INIs and its relation to HIV-2 integrase gene polymorphism.

Methods: We determined the phenotypic susceptibility to raltegravir and elvitegravir of co-cultured isolates obtained from the HIV-2 ROD reference strain and from 14 clinical isolates. IC(50) values were compared with those for HIV-1 reference strains. HIV-2 integrase gene polymorphism was assessed in isolates from 52 INI-naive patients enrolled in the French HIV-2 cohort.

Results: Median raltegravir and elvitegravir IC(50) values for the 14 clinical HIV-2 isolates were 2.4 and 0.7 nM, respectively, and were similar to those observed for HIV-2 ROD and HIV-1 reference strains. Overall, 38% of HIV-2 integrase amino acids were polymorphic. The catalytic triad DDE and the HHCC and RKK motifs were fully conserved, at the same genomic positions as described in HIV-1. In subtype B isolates, the total length of the integrase gene varied, owing to the presence of stop codons at positions 288, 294, 297 and 302. Fourteen of the positions associated with substitutions conferring INI resistance in HIV-1 were polymorphic in HIV-2.

Conclusions: Despite 40% heterogeneity between the HIV-1 and HIV-2 integrase genes, the phenotypic susceptibility of clinical HIV-2 isolates to INIs was similar to that of HIV-1. This new class of antiretroviral drugs thus represents a novel therapeutic possibility for HIV-2-infected patients who otherwise have few treatment options.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amino Acid Sequence
  • Amino Acid Substitution / genetics
  • Catalytic Domain
  • Codon, Nonsense
  • Cohort Studies
  • Conserved Sequence
  • Drug Resistance, Viral*
  • France
  • HIV Infections / virology
  • HIV Integrase / genetics*
  • HIV-1 / drug effects
  • HIV-2 / drug effects*
  • HIV-2 / isolation & purification
  • Humans
  • Inhibitory Concentration 50
  • Integrase Inhibitors / pharmacology*
  • Microbial Sensitivity Tests
  • Molecular Sequence Data
  • Mutation, Missense
  • Polymorphism, Genetic*
  • Pyrrolidinones / pharmacology*
  • Quinolones / pharmacology*
  • Raltegravir Potassium

Substances

  • Codon, Nonsense
  • Integrase Inhibitors
  • Pyrrolidinones
  • Quinolones
  • Raltegravir Potassium
  • elvitegravir
  • HIV Integrase
  • p31 integrase protein, Human immunodeficiency virus 2