Clinical significance of HIV reverse-transcriptase inhibitor-resistance mutations

Future Microbiol. 2011 Mar;6(3):295-315. doi: 10.2217/fmb.11.7.

Abstract

In this article, we summarize recent knowledge on drug-resistance mutations within HIV reverse transcriptase (RT). Several large-scale HIV-1 genotypic analyses have revealed that the most prevalent nucleos(t)ide analog RT inhibitor (NRTI)-resistance mutation is M184V/I followed by a series of thymidine analog-associated mutations: M41L, D67N, K70R, L210W, T215Y/F and K219Q/E. Among non-nucleoside RT inhibitor (NNRTI)-resistance mutations, K103N was frequently observed, followed by Y181C and G190A. Interestingly, V106M was identified in HIV-1 subtype C as a subtype-specific multi-NNRTI-resistance mutation. Regarding mutations in the HIV-1 RT C-terminal region, including the connection subdomain and RNase H domain, their clinical impacts are still controversial, although their effects on NRTI and NNRTI resistance have been confirmed in vitro. In HIV-2 infections, the high prevalence of the Q151M mutation associated with multi-NRTI resistance has been frequently observed.

Publication types

  • Review

MeSH terms

  • Amino Acid Substitution / genetics
  • Anti-HIV Agents / pharmacology
  • Anti-HIV Agents / therapeutic use
  • Drug Resistance, Viral*
  • HIV Infections / drug therapy
  • HIV Infections / virology*
  • HIV Reverse Transcriptase / genetics*
  • HIV-1 / drug effects*
  • HIV-1 / genetics
  • HIV-1 / isolation & purification
  • HIV-2 / drug effects*
  • HIV-2 / genetics
  • HIV-2 / isolation & purification
  • Humans
  • Mutation, Missense*

Substances

  • Anti-HIV Agents
  • reverse transcriptase, Human immunodeficiency virus 1
  • reverse transcriptase, Human immunodeficiency virus 2
  • HIV Reverse Transcriptase