Antiretroviral resistance in HIV: Difference between revisions
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*Genotyping sequences reverse transcriptase, integrase, and protease |
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*Resistance point mutations names as wild-type amino acid, position, and mutant amino acid (e.g. K '''103''' N) |
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*Bulk sequencing can only detect mutations that represent >20% of HIV |
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{| class="wikitable" |
{| class="wikitable" |
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!Drug |
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!Mutation |
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!Notes |
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! colspan=3 | |
! colspan="3" |NRTIs |
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| rowspan=7 | |
| rowspan="7" |69 insertion complex multi-NRTI resistance |
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|M '''41''' '''L''' |
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|A '''62''' '''V''' |
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|* '''69''' '''insert''' |
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|K '''70''' '''R''' |
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|L '''210''' '''W''' |
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|T '''215''' '''Y F''' |
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|K '''219''' '''Q E''' |
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| rowspan=5 | |
| rowspan="5" |151 complex multi-NRTI resistance |
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|A '''62''' '''V''' |
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|V '''75''' '''I''' |
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|F '''77''' '''L''' |
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|F '''116''' '''Y''' |
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|Q '''151''' '''M''' |
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| rowspan=6 | |
| rowspan="6" |Thymidine analogue-associated mutations (TAMs) multi-NRTI resistance |
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|M '''41''' '''L''' |
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| rowspan=6 | |
| rowspan="6" |resistance to AZT and d4T; resistance to others is proportional to the number of TAMs |
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|D '''67''' '''N''' |
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|K '''70''' '''R''' |
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|L '''210''' '''W''' |
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|T '''215''' '''Y F''' |
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|K '''219''' '''Q W''' |
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| rowspan=4 | |
| rowspan="4" |[[Abacavir]] |
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|K '''65''' '''R E N''' |
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|L '''74''' '''V''' |
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|Y '''115''' '''F''' |
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|M '''184''' '''V''' |
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|common; can still use TDF, AZT |
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| rowspan=2 | |
| rowspan="2" |[[Emtricitabine]] |
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|K '''65''' '''R E N''' |
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|M '''184''' '''V I''' |
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|common; can use ABC (if M184I), TDF, AZT; can still use FTC in combination with TDF or TAF |
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| rowspan=2 | |
| rowspan="2" |[[Lamivudine]] |
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|K '''65 '''R E N |
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|M '''184''' '''V I''' |
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|common; can use ABC (if M184I), TDF, AZT; can still use 3TC in combination with TDF or TAF |
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| rowspan=2 | |
| rowspan="2" |[[Tenofovir]] |
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|K '''65''' '''R E N''' |
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|K '''70''' '''E''' |
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| rowspan=6 | |
| rowspan="6" |[[Zidovudine]] |
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|M '''41''' '''L''' |
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|D '''67''' '''N''' |
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|K '''70''' '''R''' |
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|L '''210''' '''W''' |
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|T '''215''' '''Y F''' |
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|K '''219''' '''Q E''' |
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! colspan=3 | |
! colspan="3" |NNRTIs |
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| rowspan=7 | |
| rowspan="7" |[[Doravirine]] |
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|V '''106''' '''A''' I '''M''' T |
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|Y '''188''' C '''L''' H |
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|G '''190''' E |
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|P '''225''' H |
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|F '''227''' C L R |
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|M '''230''' L |
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|L '''234''' I |
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| rowspan=10 | |
| rowspan="10" |[[Efavirenz]] |
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|L '''100''' '''I''' |
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|K '''101''' '''P''' |
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|K '''103''' '''N S''' |
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|V '''106''' '''M''' |
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|V '''108''' '''I''' |
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|Y '''181''' '''C I''' |
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|Y '''188''' '''L''' |
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|G '''190''' '''S A''' |
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|P '''225''' '''H''' |
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|M '''230''' '''L''' |
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| rowspan=9 | |
| rowspan="9" |[[Nevirapine]] |
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|L '''100''' '''I''' |
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|K '''101''' '''P''' |
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|K '''103''' '''N S''' |
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|V '''106''' '''A M''' |
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|V '''108''' '''I''' |
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|Y '''181''' '''C I''' |
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|Y '''188''' '''C L H''' |
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|G '''190''' '''A''' |
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|M '''230''' '''L''' |
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| rowspan=9 | |
| rowspan="9" |[[Rilpivirine]] |
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|L '''100''' '''I''' |
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|K '''101''' '''E P''' |
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|E '''138''' '''A G K Q R''' |
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|V '''179''' '''L''' |
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|Y '''181''' '''C I V''' |
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|Y '''188''' '''L''' |
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|H '''221''' '''Y''' |
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|F '''227''' '''C''' |
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|M '''230''' '''I L''' |
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! colspan=3 | |
! colspan="3" |Protease inhibitors |
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| rowspan=24 | |
| rowspan="24" |[[Atazanavir]] |
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|L '''10''' I F V C |
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|G '''16''' E |
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|K '''20''' R M I T V |
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|L '''24''' I |
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|V '''32''' I |
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|L '''33''' I F V |
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|E '''34''' Q |
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|M '''36''' I L V |
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|M '''46''' I L |
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|G '''48''' V |
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|I '''50''' '''L''' |
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|F '''53''' L Y |
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|I '''54''' L V M T A |
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|D '''60''' E |
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|I '''62''' V |
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|I '''64''' L M V |
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|A '''71''' V I T L |
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|G '''73''' C S T A |
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|V 82 A T F I |
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|I '''84''' '''V''' |
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|I 85 V |
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|N '''88''' '''S''' |
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|L 90 M |
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|I 93 L M |
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| rowspan=10 | |
| rowspan="10" |[[Darunavir]] |
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|V 11 I |
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|V 32 I |
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|L 33 F |
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|I '''47''' '''V''' |
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|I '''50''' '''V''' |
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|I '''54''' '''M L''' |
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|T 74 P |
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|L '''76''' '''V''' |
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|I '''84''' '''V''' |
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|L 89 V |
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! colspan=3 | |
! colspan="3" |INSTIs |
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| rowspan=5 | |
| rowspan="5" |[[Bictegravir]] |
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|G 118 R |
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|E 138 K |
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|G 140 S |
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|Q '''148''' '''H''' |
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|R '''263''' '''K''' |
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| rowspan=8 | |
| rowspan="8" |[[Cabotegravir]] |
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|T 66 K |
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|G '''118''' '''R''' |
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|E 138 A K T |
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|G '''140''' A C '''R''' S |
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|Q '''148''' '''H K R''' |
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|S 153 F Y |
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|N 155 H |
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|R '''263''' '''K''' |
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| rowspan=7 | |
| rowspan="7" |[[Dolutegravir]] |
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|G '''118''' '''R''' |
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|F 121 Y |
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|E 138 A K T |
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|G 140 A S |
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|Q '''148''' '''H K R''' |
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|N 155 H |
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|R '''263''' '''K''' |
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| rowspan=8 | |
| rowspan="8" |[[Elvitegravir]] |
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|T '''66''' '''I''' A K |
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|E '''92''' '''Q''' G |
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|T 97 A |
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|F '''121''' '''Y''' |
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|S '''147''' '''G''' |
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|Q '''148''' '''H K R''' |
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|N '''155''' '''H''' |
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|R '''263''' '''K''' |
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| rowspan=10 | |
| rowspan="10" |[[Raltegravir]] |
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|L 74 M |
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|E 92 Q |
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|T 97 A |
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|F '''121''' '''Y''' |
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|E 138 A K |
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|G 140 A S |
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|Y '''143''' '''R H C''' |
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|Q '''148''' '''H K R''' |
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|N '''155''' '''H''' |
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|R '''263''' '''K''' |
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Revision as of 11:56, 28 August 2020
- 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
Drug | Mutation | Notes |
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NRTIs | ||
69 insertion complex multi-NRTI resistance | M 41 L | |
A 62 V | ||
* 69 insert | ||
K 70 R | ||
L 210 W | ||
T 215 Y F | ||
K 219 Q E | ||
151 complex multi-NRTI resistance | A 62 V | |
V 75 I | ||
F 77 L | ||
F 116 Y | ||
Q 151 M | ||
Thymidine analogue-associated mutations (TAMs) multi-NRTI resistance | M 41 L | resistance to AZT and d4T; resistance to others is proportional to the number of TAMs |
D 67 N | ||
K 70 R | ||
L 210 W | ||
T 215 Y F | ||
K 219 Q W | ||
Abacavir | K 65 R E N | |
L 74 V | ||
Y 115 F | ||
M 184 V | common; can still use TDF, AZT | |
Emtricitabine | K 65 R E N | |
M 184 V I | common; can use ABC (if M184I), TDF, AZT; can still use FTC in combination with TDF or TAF | |
Lamivudine | K 65 R E N | |
M 184 V I | common; can use ABC (if M184I), TDF, AZT; can still use 3TC in combination with TDF or TAF | |
Tenofovir | K 65 R E N | |
K 70 E | ||
Zidovudine | M 41 L | |
D 67 N | ||
K 70 R | ||
L 210 W | ||
T 215 Y F | ||
K 219 Q E | ||
NNRTIs | ||
Doravirine | V 106 A I M T | |
Y 188 C L H | ||
G 190 E | ||
P 225 H | ||
F 227 C L R | ||
M 230 L | ||
L 234 I | ||
Efavirenz | L 100 I | |
K 101 P | ||
K 103 N S | ||
V 106 M | ||
V 108 I | ||
Y 181 C I | ||
Y 188 L | ||
G 190 S A | ||
P 225 H | ||
M 230 L | ||
Nevirapine | L 100 I | |
K 101 P | ||
K 103 N S | ||
V 106 A M | ||
V 108 I | ||
Y 181 C I | ||
Y 188 C L H | ||
G 190 A | ||
M 230 L | ||
Rilpivirine | L 100 I | |
K 101 E P | ||
E 138 A G K Q R | ||
V 179 L | ||
Y 181 C I V | ||
Y 188 L | ||
H 221 Y | ||
F 227 C | ||
M 230 I L | ||
Protease inhibitors | ||
Atazanavir | L 10 I F V C | |
G 16 E | ||
K 20 R M I T V | ||
L 24 I | ||
V 32 I | ||
L 33 I F V | ||
E 34 Q | ||
M 36 I L V | ||
M 46 I L | ||
G 48 V | ||
I 50 L | ||
F 53 L Y | ||
I 54 L V M T A | ||
D 60 E | ||
I 62 V | ||
I 64 L M V | ||
A 71 V I T L | ||
G 73 C S T A | ||
V 82 A T F I | ||
I 84 V | ||
I 85 V | ||
N 88 S | ||
L 90 M | ||
I 93 L M | ||
Darunavir | V 11 I | |
V 32 I | ||
L 33 F | ||
I 47 V | ||
I 50 V | ||
I 54 M L | ||
T 74 P | ||
L 76 V | ||
I 84 V | ||
L 89 V | ||
INSTIs | ||
Bictegravir | G 118 R | |
E 138 K | ||
G 140 S | ||
Q 148 H | ||
R 263 K | ||
Cabotegravir | T 66 K | |
G 118 R | ||
E 138 A K T | ||
G 140 A C R S | ||
Q 148 H K R | ||
S 153 F Y | ||
N 155 H | ||
R 263 K | ||
Dolutegravir | G 118 R | |
F 121 Y | ||
E 138 A K T | ||
G 140 A S | ||
Q 148 H K R | ||
N 155 H | ||
R 263 K | ||
Elvitegravir | T 66 I A K | |
E 92 Q G | ||
T 97 A | ||
F 121 Y | ||
S 147 G | ||
Q 148 H K R | ||
N 155 H | ||
R 263 K | ||
Raltegravir | L 74 M | |
E 92 Q | ||
T 97 A | ||
F 121 Y | ||
E 138 A K | ||
G 140 A S | ||
Y 143 R H C | ||
Q 148 H K R | ||
N 155 H | ||
R 263 K |