Impact of INSTI on a Drug-Resistant Mutation (S68S Insertion) in a Patient Infected with HIV-1 CRF06_cpx

Previously, we reported a T69S insertion in the circulating recombinant form 06_cpx in a patient infected with HIV-1 during the perinatal period. Through this study, we found that the T69S insertion in our previous report was actually an S68S insertion. The patient was treated with zidovudine and didanosine, followed by combination antiretroviral therapy. The introduction of Korean Red Ginseng (KRG) completely suppressed plasma viral RNA to <20 copies/mL and reverted the S68S insertion to wild-type; there was no evidence of an S68S insertion for 3 years. Here, we report the impact of integrase strand transfer inhibitor (INSTI) treatment on drug resistance mutations (DRMs) over a further 10 years. The S68S insertion disappeared after 3 months of INSTI therapy, and the number of DRMs decreased. There were no major DRMs to INSTI in either the patient or her parents. These data highlight the utility of combination therapy with INSTI and KRG.