Viral dynamics and mutations in the pol gene during primary HIV-1 infection

The understanding of viral dynamics and appearance of mutations during prim ary infection could be useful for the design of an efficient therapy. For t his reason a cohort of samples from naive primary patients was examined. Th e results pointed out that only a few secondary mutations in protease gene (having no effect on resistance) were found, while a single mutation confer ring resistance to non-nucleosides inhibitors of reverse transcriptase was found both in plasma and cerebrospinal fluid of a patient. As both the protease secondary mutations and the single non nucleoside reve rse transcriptase mutation map far from the catalytical sites of the enzyme s, neither one is able to impair viral fitness. Overall data suggest that t reated donors carrying resistant strains may be in part unable to transfer them to the recipient, and/or virus in the recipient tends to revert to wil d type. These results should be taken into account in the planning of early HAART treatment of HIV infection.