Antiretroviral resistance in HIV: Difference between revisions

Revision as of 20:25, 5 July 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
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
Emtricitabine	M 184 V I	common; can use ABC (if M184I), TDF, AZT
Lamivudine	K 65 R E N
Lamivudine	M 184 V I	common; can use ABC (if M184I), TDF, AZT
Tenofovir	K 65 R E N
Tenofovir	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

@@ Line 6: / Line 6: @@
 ! Drug
 ! Mutation
+! Notes
 |-
-! colspan=2 | NRTIs
+! colspan=3 | NRTIs
 |-
 | rowspan=7 | 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'''
+|
 |-
 | rowspan=5 | 151 complex multi-NRTI resistance
 | A '''62''' '''V'''
+|
 |-
 | V '''75''' '''I'''
+|
 |-
 | F '''77''' '''L'''
+|
 |-
 | F '''116''' '''Y'''
+|
 |-
 | Q '''151''' '''M'''
+|
 |-
 | rowspan=6 | Thymidine analogue-associated mutations (TAMs) multi-NRTI resistance
 | M '''41''' '''L'''
+| rowspan=6 | resistance to AZT and d4T; resistance to others is proportional to the number of TAMs
 |-
 | D '''67''' '''N'''
@@ Line 50: / Line 64: @@
 | rowspan=4 | [[Abacavir]]
 | K '''65''' '''R E N'''
+|
 |-
 | L '''74''' '''V'''
+|
 |-
 | Y '''115''' '''F'''
+|
 |-
 | M '''184''' '''V'''
+| common; can still use TDF, AZT
 |-
 | rowspan=2 | [[Emtricitabine]]
 | K '''65''' '''R E N'''
+|
 |-
 | M '''184''' '''V I'''
+| common; can use ABC (if M184I), TDF, AZT
 |-
 | rowspan=2 | [[Lamivudine]]
 | K '''65 '''R E N'''
+|
 |-
 | M '''184''' '''V I'''
+| common; can use ABC (if M184I), TDF, AZT
 |-
 | rowspan=2 | [[Tenofovir]]
 | K '''65''' '''R E N'''
+|
 |-
 | K '''70''' '''E'''
+|
 |-
 | rowspan=6 | [[Zidovudine]]
 | M '''41''' '''L'''
+|
 |-
 | D '''67''' '''N'''
+|
 |-
 | K '''70''' '''R'''
+|
 |-
 | L '''210''' '''W'''
+|
 |-
 | T '''215''' '''Y F'''
+|
 |-
 | K '''219''' '''Q E'''
+|
 |-
-! colspan=2 | NNRTIs
+! colspan=3 | NNRTIs
 |-
 | rowspan=7 | [[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
+|
 |-
 | rowspan=10 | [[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'''
+|
 |-
 | rowspan=9 | [[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'''
+|
 |-
 | rowspan=9 | [[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'''
+|
 |-
-! colspan=2 | Protease inhibitors
+! colspan=3 | Protease inhibitors
 |-
 | rowspan=24 | [[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
+|
 |-
 | rowspan=10 | [[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
+|
 |-
-! colspan=2 | INSTIs
+! colspan=3 | INSTIs
 |-
 | rowspan=5 | [[Bictegravir]]
 | G 118 R
+|
 |-
 | E 138 K
+|
 |-
 | G 140 S
+|
 |-
 | Q '''148''' '''H'''
+|
 |-
 | R '''263''' '''K'''
+|
 |-
 | rowspan=8 | [[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'''
+|
 |-
 | rowspan=7 | [[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'''
+|
 |-
 | rowspan=8 | [[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'''
+|
 |-
 | rowspan=10 | [[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'''
+|
 |}