The utility of coreceptor typing in the clinic

  • Eoin Coakley
Part of the Milestones in Drug Therapy book series (MDT)


HIV enters cells through critical interactions of the viral envelope protein (Env) with the CD4 receptor and a chemokine coreceptor, typically CCR5 or CXCR4 [1]. This chapter focuses on these two most clinically relevant coreceptors. Based upon the pattern of coreceptor utilization, a virus may be classified as exhibiting one of three phenotypes; a virus using only CCR5 is R5 tropic, one that uses only CXCR4 is X4 and one that can use either coreceptor is R5X4 or dual tropic. Since HIV commonly exists within a patient as a mixture of viruses with different tropisms, there is a fourth possible determination, mixed tropism. For example, a single HIV plasma sample may contain R5 as well as X4 or R5X4 viruses. Population-based coreceptor typing assays cannot distinguish between truly dual tropic viral populations and those that are mixed. Therefore the detection of both R5 and X4 tropism in a sample is reported as dual/mixed (DM).


Human Immunodeficiency Virus Type West Nile Virus CCR5 Antagonist Coreceptor Usage Optimize Background Therapy 
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Copyright information

© Birkhäuser Verlag/Switzerland 2007

Authors and Affiliations

  • Eoin Coakley
    • 1
  1. 1.Monogram BiosciencesSouth San FranciscoUSA

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