Open AccessFailure of Initial Therapy With Two Nucleosides and Efavirenz Is Not Associated With Early Emergence of Mutations in the C-Terminus of HIV-1 Reverse Transcriptase
Author(s) -
Jessica H. Brehm,
Christina M. Lalama,
Michael D. Hughes,
Richard Haubrich,
Sharon A. Riddler,
Nicolas SluisCremer,
John W. Mellors
Publication year - 2011
Publication title -
journal of acquired immune deficiency syndromes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.162
H-Index - 157
eISSN - 1944-7884
pISSN - 1525-4135
DOI - 10.1097/qai.0b013e31820cf029
Subject(s) - efavirenz , reverse transcriptase , rnase h , virology , human immunodeficiency virus (hiv) , zidovudine , nevirapine , reverse transcriptase inhibitor , mutation , antiretroviral therapy , biology , medicine , viral load , polymerase chain reaction , genetics , viral disease , gene
It is uncertain how often mutations in the connection or RNase H domains of HIV-1 reverse transcriptase (RT) emerge with failure of first-line antiretroviral therapy. Full-length RT sequences in plasma obtained pretherapy and at virologic failure were compared in 53 patients on first-line efavirenz-containing regimens from AIDS Clinical Trials Group study A5142. HIV-1 was mostly subtype B (48 of 53). Mutations in the polymerase but not in connection or RNase H domains of RT increased in frequency between pretherapy and failure (K103N, P = 0.001; M184I/V, P = 0.016). Selection of mutations in C-terminal domains of RT is not common with early failure of efavirenz-containing regimens.