Ks. Dorman et al., Mutation takes no vacation: Can structured treatment interruptions increase the risk of drug-resistant HIV-1?, J ACQ IMM D, 25(5), 2000, pp. 398-402
We use a mathematical model to study the dynamics of HIV-1 replication duri
ng structured treatment interruptions (STIs) in infected patients. The mode
l predicts rapid viral rebound, restoration of a latently infected cell poo
l, and critically, partially resistant mutant rebound that may be missed be
cause of high levels of wild type virus. Because partially resistant viruse
s are capable of mutating to full resistance, a substantial increase in the
ir numbers represents a threat to therapeutic response durability. Compared
with continued treatment, STIs may increase the chance of mutation to full
resistance by several thousandfold.