title: Heterosexual transmission of human immunodeficiency virus type 1 variants associated with zidovudine resistance.
abstract: During zidovudine therapy, human immunodeficiency virus type 1 (HIV-1) acquires a distinctive set of mutations that diminish the sensitivity of the virus to this drug in vitro. An AIDS patient is described who, while being treated with zidovudine, transmitted HIV-1 bearing a drug resistance mutation to a young woman who had never received zidovudine treatment. DNA sequencing of HIV-1 proviruses confirmed that these 2 persons shared HIV genetic variants, including a mutation at codon 70 in the reverse transcriptase gene associated with reduced in vitro sensitivity to zidovudine. This mutation persisted in the woman > 1 year in the absence of antiretroviral therapy. HIV-1 with genetic markers of zidovudine resistance can be transmitted heterosexually, but it is uncertain whether dissemination of drug-resistant virus will substantially reduce the usefulness of this drug.
authors.affiliation: Infectious Diseases Unit, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Oxford, United Kingdom.
authors.forename: C P
authors.initials: CP
authors.lastname: Conlon
authors.forename: P
authors.initials: P
authors.lastname: Klenerman
authors.forename: A
authors.initials: A
authors.lastname: Edwards
authors.forename: B A
authors.initials: BA
authors.lastname: Larder
authors.forename: R E
authors.initials: RE
authors.lastname: Phillips
mesh_terms: D000328:Adult; D001483:Base Sequence; D017931:DNA Primers / Q000737:chemistry; D004352:Drug Resistance, Microbial; D005260:Female; D014644:Genetic Variation; D015658:HIV Infections / Q000635:transmission*; D054303:HIV Reverse Transcriptase; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D017354:Point Mutation; D016133:Polymerase Chain Reaction; D012194:RNA-Directed DNA Polymerase / Q000235:genetics; D012725:Sexual Behavior; D013997:Time Factors; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D017931:DNA Primers; D015215:Zidovudine; D054303:HIV Reverse Transcriptase; D012194:RNA-Directed DNA Polymerase