Antiretroviral resistance in HIV

From IDWiki
  • Genotyping sequences reverse transcriptase, integrase, and protease
  • Resistance point mutations names as wild-type amino acid, position, and mutant amino acid (e.g. K 103 N)
  • Bulk sequencing can only detect mutations that represent >20% of HIV

Common Mutations

All Mutations

Drug Mutation Notes
NRTIs
69 insertion complex M41L multi-NRTI resistance
A62V
* 69 insert
K70R
L210W
T215YF
K219QE
151 complex A62V multi-NRTI resistance
V75I
F77L
F116Y
Q151M
Thymidine analogue-associated mutations (TAMs) M41L resistance to AZT and d4T; resistance to others is proportional to the number of TAMs, and with 4 or more mutations there is resistance to essentially all NRTIs
D67N
K70R
L210W
T215Y/F
K219Q/W
Abacavir K65R/E/N common
L74V
Y115F
M184V common; can still use TDF, AZT
Emtricitabine K65R/E/N common
M184V/I common; can use ABC (if M184I), TDF, AZT; can still use FTC in combination with TDF or TAF
Lamivudine K65R/E/N common
M184V/I common; can use ABC (if M184I), TDF, AZT; can still use 3TC in combination with TDF or TAF
Tenofovir K65R/E/N common
K70E
Zidovudine M41L
D67N
K70R
L210W
T215Y/F
K219Q/E
NNRTIs
Doravirine V106A/I/M/T
Y188C/L/H
G190E
P225H
F227C/L/R
M230L
L234I
Efavirenz L100I
K101P
K103N/S
V106M
V108I
Y181C/I
Y188L
G190S/A
P225H
M230L
Nevirapine L100I
K101P
K103N/S
V106A/M
V108I
Y181C/I common
Y188C/L/H
G190A
M230L
Rilpivirine L100I
K101E/P common
E138A/G/K/Q/R common
V179L
Y181C/I/V common
Y188L
H221Y
F227C
M230I/L
Protease inhibitors
Atazanavir L10I/F/V/C
G16E
K20R/M/I/T/V
L24I
V32I
L33I/F/V
E34Q
M36I/L/V
M46I/L
G48V
I50L common
F53L/Y
I54L/V/M/T/A
D60E
I62V
I64L/M/V
A71V/I/T/L
G73C/S/T/A
V82A/T/F/I
I84V
I85V
N88S
L90M
I93L/M
Darunavir V11I
V32I
L33F
I47V
I50V
I54M/L
T74P
L76V
I84V
L89V
INSTIs
Bictegravir G118R
E138K
G140S
Q148H
R263K
Cabotegravir T66K
G118R
E138A/K/T
G140A/C/R/S
Q148H/K/R
S153F/Y
N155H
R263K
Dolutegravir G118R
F121Y
E138A/K/T
G140A/S
Q148H/K/R
N155H
R263K common
Elvitegravir T66I/A/K
E92Q/G
T97A
F121Y
S147G
Q148H/K/R common
N155H common
R263K
Raltegravir L74M
E92Q
T97A
F121Y
E138A/K
G140A/S
Y143R/H/C common
Q148H/K/R common
N155H common
R263K