Analysis of env sequence evolution in human immunodeficiency virus-infected patients receiving therapy with nonnucleoside reverse-transcriptase inhibitors

Nonnucleoside reverse-transcriptase inhibitors (NNRTIs) can rapidly select for drug-resistant human immunodeficiency virus type 1 (HIV-1) variants, al though their effect on HIV-1 quasi-species diversity is unknown. To determi ne if changes in env gene diversification occur with NNRTI: therapy, we use d the heteroduplex tracking assay (HTA) to study HIV-1 env sequence diversi ty in 2 groups of patients: those who were on no therapy or were on chronic antiretroviral therapy and those who had just initiated NNRTIs. Forty-nine paired samples from 46 patients were analyzed, Fourteen of 32 paired sampl es from the NNRTI group and 9 of 17 paired samples from the control group h ad HTA changes (P > .10). There was no correlation between HTA change and s ampling time interval, baseline virus load, change in virus load, or develo pment of NNRTI resistance. Thus, we found no significant correlation of NNR TI therapy with changes in env HTA patterns, suggesting that these treatmen ts had little short-term impact on HIV-1 quasi-species diversity.