Rescue of HIV-1 long-time archived X4 strains to escape maraviroc

► Investigation of HIV-1 coreceptor usage in a patient failing maraviroc treatment. ► Coreceptor usage is assessed genotypically and phenotypically. ► Phylogenetic analysis is performed on V3-loop sequences. ► Recombination plays a key role in rescuing X4 strains that lead to maraviroc failure. ► Interleukin-2 has a strong impact on viral population diversity.