Apr 15, 2003
Dr. Young. Hi. If a person is infected with a resistant virus will this strain eventually revert back to a wild type? If so is there anything in the literature to support this theory? Thanks, Stan
Response from Dr. Young
Stan- thanks for the question.
The answer about back-reversion to wild type for initial infection with resistant virus depends a lot on the particulars of which mutations were transmitted. Our initial view of this was that all mutant viruses probably back reverted to wild type, and therefore could not be detected after the acute infection phase.
Much of this premise was derived from observations of virus among persons who were infected with wild type virus, and then selected drug resistance. If the drug therapy (and selective pressure) is stopped, the viral population rapidly reverted to wild type. One excellent example of this were studies by Condra and colleagues looking at indinavir resistance in the late 1990s.
Recent studies from Susan Little and colleagues have definately shown this not to be the case, at least for mutations like K103N, that confers resistance to non-nucleoside drugs. In a presenation last year, she reported about the long-term persistence of this mutations among persons who were infected with the resistant strain and never received non-nucleoside therapy.
I think that the reason for this might have something to do with the impact of particular mutations on the replications capacity of the virus-- and different mutations have different effects.
I hope this begins to answer your question. BY
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