Patterns of resistance mutations selected by treatment of human immunodeficiency virus type 1 infection with zidovudine, didanosine, and nevirapine

George J. Hanna, Victoria A. Johnson, Daniel R. Kuritzkes, Douglas D. Richman, Andrew J. Leigh Brown, Anu V. Savara, J. Darren Hazelwood, Richard T. D'Aquila*

*Corresponding author for this work

Research output: Contribution to journalArticle

110 Scopus citations

Abstract

Resistance mutations selected in reverse transcriptase (RT) by incompletely suppressive therapy with combination zidovudine and didanosine with or without nevirapine were identified in 141 human immunodeficiency virus type 1 isolates from peripheral blood mononuclear cells of 57 individuals in the AIDS Clinical Trials Group protocol 241. After prolonged treatment (16-48 weeks), the most common nevirapine-selected mutations were RT 181C (15/30 isolates [50%]), 190A (15/30 [50%]), and 101E (9/30 [30%]). RT 103N and 188L, which individually confer cross-resistance to all nonnucleoside RT inhibitors, were seen in a minority of viruses (6/30 [20%] and 4/30 [13%], respectively). Didanosine-resistance mutations arose rarely. A newly recognized mutation, RT 44D, was selected by the nucleosides. Two distinct zidovudine-resistance mutational patterns were noted. Mutations selected during treatment with zidovudine, didanosine, and nevirapine differed among individuals and changed over time. Resistance testing is necessary to identify which mutations are selected by nevirapine-containing combinations.

Original languageEnglish (US)
Pages (from-to)904-911
Number of pages8
JournalJournal of Infectious Diseases
Volume181
Issue number3
DOIs
StatePublished - Apr 19 2000

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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