FIG 3.

Sensitivity of plasma virus and PMBC GRT in patients who discontinue ART following VF and emergent HIV drug resistance (HIVDR). Rx followed by an arrow indicates the period of antiviral therapy. Most DRMs will no longer be detectable by plasma virus GRT within 2 to 3 months following ART discontinuation because plasma viruses containing DRMs are often rapidly outcompeted by ancestral wild-type viruses established in viral reservoirs prior to ART initiation. Although recently emergent DRMs may have begun to seed the proviral DNA reservoir, their levels in this compartment will be low unless VF has been prolonged. In addition, the presence of unintegrated linear and episomal viral DNA, which are in equilibrium with circulating plasma virus, may also reduce the proportion of viral DNA molecules containing DRMs. In the boxed figure on the right, proviral DNA containing DRMs are indicated by red asterisks. Unintegrated linear viral DNA is shown outside the nucleus. Episomal DNA is not shown; its dynamics are likely to be closer to unintegrated linear DNA than proviral DNA.