title: HIV-1 subtype C reverse transcriptase and protease genotypes in Zimbabwean patients failing antiretroviral therapy.
abstract: HIV-1 drug resistance mutations have been identified and characterized mostly in subtype B HIV-1 infection. The extent to which antiretroviral drugs select for drug resistance mutations in non-subtype B HIV-1 is not known. We obtained HIV-1 reverse transcriptase (RT) and protease sequences from 21 Zimbabwean patients failing antiretroviral drug therapy. We compared these sequences with 56 published RT and protease subtype C sequences from untreated patients, 990 RT and 1140 protease subtype B sequences from treated patients, and 340 RT and 907 protease subtype B sequences from untreated patients and identified four mutation categories of subtype C HIV-1. Seventeen of the 21 patients (81%) had known drug resistance mutations. Mutations at 15 RT and 11 protease positions were more common in subtype C isolates than in subtype B isolates. HIV-1 subtype C-infected individuals receiving antiretroviral therapy develop many of the known subtype B drug resistance mutations. Comparison of subtype C RT and protease sequences with a large database of subtype B sequences identified subtype C-specific polymorphisms and candidate drug resistance mutations.
authors.affiliation: Division of Infectious Diseases and AIDS Research, Stanford University, California 94305, USA. rkantor@stanford.edu
authors.forename: Rami
authors.initials: R
authors.lastname: Kantor
authors.forename: Lynn S
authors.initials: LS
authors.lastname: Zijenah
authors.forename: Robert W
authors.initials: RW
authors.lastname: Shafer
authors.forename: Solomon
authors.initials: S
authors.lastname: Mutetwa
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Johnston
authors.forename: Robert
authors.initials: R
authors.lastname: Lloyd
authors.forename: Andrea
authors.initials: A
authors.lastname: von Lieven
authors.forename: Dennis
authors.initials: D
authors.lastname: Israelski
authors.forename: David A
authors.initials: DA
authors.lastname: Katzenstein
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D024882:Drug Resistance, Viral / Q000235:genetics*; D004359:Drug Therapy, Combination; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D016333:HIV Protease / Q000235:genetics*; D054303:HIV Reverse Transcriptase / Q000235:genetics*; D015497:HIV-1 / Q000145:classification* / Q000201:enzymology / Q000235:genetics; D006801:Humans; D008969:Molecular Sequence Data; D009154:Mutation; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D017422:Sequence Analysis, DNA; D017211:Treatment Failure; D015030:Zimbabwe
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D054303:HIV Reverse Transcriptase; D016333:HIV Protease