Optimization of an Antiviral Treatment Regimen for Immunological Nonresponders Through HIV-DNA Resistance Testing: A Case Report

In August 2012, a 47-year-old male patient was diagnosed with human immunodeficiency virus (HIV) infection, with no other underlying disease or opportunistic infection. Baseline measurements revealed an HIV RNA count of 79 400 copies/mL and a CD4+ T-lymphocyte count of 8 cells/μL. Despite successful viral suppression with HIV RNA levels remaining below the detectable threshold for 9 consecutive years following the initiation of antiretroviral therapy, the patient's CD4+ T lymphocyte count persistently remained below 200 cells/μL. Resistance testing of the viral reservoir (HIV DNA) was conducted, which revealed proviral resistance. Based on these results, the antiviral treatment regimen was adjusted. One year later, the patient's immune function had significantly improved, with the CD4+ T lymphocyte count having increased to 319 cells/μL.