Antiretroviral resistance in HIV: Difference between revisions

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* Genotyping sequences reverse transcriptase, integrase, and protease
*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)
*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
*Bulk sequencing can only detect mutations that represent >20% of HIV


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

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
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
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