title: Reduced susceptibility of human immunodeficiency virus type 1 (HIV-1) from patients with primary HIV infection to nonnucleoside reverse transcriptase inhibitors is associated with variation at novel amino acid sites.
abstract: Recently, significant numbers of individuals with primary human immunodeficiency virus (HIV) infection have been found to harbor viral strains with reduced susceptibility to antiretroviral drugs. In one study, HIV from 16% of such antiretroviral-naive individuals was shown to have a susceptibility to nonnucleoside reverse transcriptase (RT) inhibitors (NNRTIs) between 2.5- and 10-fold lower than that of a wild-type control. Mutations in the RT domain that had previously been associated with antiretroviral resistance were not shared by these strains. We have analyzed by logistic regression 46 variable amino acid sites in RT for their effect on susceptibility and have identified two novel sites influencing susceptibility to NNRTIs: amino acids 135 and 283 in RT. Eight different combinations of amino acids at these sites were observed among these patients. These combinations showed a 14-fold range in mean susceptibility to both nevirapine and delavirdine. In vitro mutagenesis of the control strain combined with a phenotypic assay confirmed the significance of amino acid variation at these sites for susceptibility to NNRTIs.
authors.affiliation: Centre for HIV Research, Institute of Cell, Animal and Population Biology, University of Edinburgh, Edinburgh, Scotland. A.Leigh-Brown@ed.ac.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Brown
authors.forename: H M
authors.initials: HM
authors.lastname: Precious
authors.forename: J M
authors.initials: JM
authors.lastname: Whitcomb
authors.forename: J K
authors.initials: JK
authors.lastname: Wong
authors.forename: M
authors.initials: M
authors.lastname: Quigg
authors.forename: W
authors.initials: W
authors.lastname: Huang
authors.forename: E S
authors.initials: ES
authors.lastname: Daar
authors.forename: R T
authors.initials: RT
authors.lastname: D'Aquila
authors.forename: P H
authors.initials: PH
authors.lastname: Keiser
authors.forename: E
authors.initials: E
authors.lastname: Connick
authors.forename: N S
authors.initials: NS
authors.lastname: Hellmann
authors.forename: C J
authors.initials: CJ
authors.lastname: Petropoulos
authors.forename: D D
authors.initials: DD
authors.lastname: Richman
authors.forename: S J
authors.initials: SJ
authors.lastname: Little
mesh_terms: D019943:Amino Acid Substitution; D004352:Drug Resistance, Microbial; D014644:Genetic Variation; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology*; D054303:HIV Reverse Transcriptase / Q000737:chemistry / Q000235:genetics*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D008969:Molecular Sequence Data; D016297:Mutagenesis, Site-Directed; D010641:Phenotype; D010802:Phylogeny; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D018894:Reverse Transcriptase Inhibitors; D054303:HIV Reverse Transcriptase