New escape route for HIV

A big problem in the treatment of HIV infections is the development of HIV strains that don’t respond to drugs, and the transmission of these resistant strains. This reduces the effectiveness of the therapy and sometimes untreatable infections develop that can result in the death of the patient. Inhibiting the viral enzyme protease is an important part of the treatment strategy for HIV. The protease inhibitors bind to the viral enzyme, which prevents the virus from reproducing further. The virus initially becomes resistant to the protease inhibitors as a result of changes to the protease enzyme itself, and the inhibitors can no longer bind to it. A new class of protease inhibitors has been developed to get around the virus’s classic resistance strategy.
However, HIV is resourceful and has another plan in reserve. Noortje van Maarseveen discovered that HIV can become resistant to this new class of protease inhibitors by using another strategy. She unraveled the mechanism behind this new escape route, showing that resistant viruses that come from patients do in fact use this resistance mechanism. This implies that laboratory methods used around the world to demonstrate resistance will have to be modified. Clinical studies are also needed to determine how often the new resistance mechanism occurs and the possible clinical consequences for this.

Noortje van Maarseveen

Evolution of HIV-1 protease inhibitor resistance

PhD advisor: Prof. J. Verhoef
Co-advisor 1: Dr. C.A.B. Boucher
Co-advisor 2: Dr. M. Nijhuis