Antiretroviral resistance in HIV: Difference between revisions

Revision as of 07:56, 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
Emtricitabine	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
Lamivudine	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
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 1: / Line 1: @@
-* 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"
-! 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'''
 |
 |}