In vitro resistance selection with doravirine (MK-1439), a novel nonnucleoside reverse transcriptase inhibitor with distinct mutation development pathways.
Doravirine (DOR, formerly known as MK-1439) is a human immunodeficiency type 1 virus (HIV-1) nonnucleoside reverse transcriptase inhibitor (NNRTI) that is currently in phase 2b clinical trials. In vitro resistance selection of subtype B virus (MT4-green fluorescent protein [GFP] cells), as well as subtype A and C viruses (MT4-GFP/CCR5 cells) was conducted with DOR, rilpivirine (RPV), and efavirine (EFV) under low-multiplicity-of-infection conditions in a 96-well format. Resistance selection was performed with escalating concentrations of the NNRTIs ranging from the 95% effective concentration (1 × EC(95)) to 1,000 × EC(95) in the presence of 10% fetal bovine serum. In the resistance selection of subtype B virus with DOR, a V106A mutant virus led to two mutation pathways, followed by the emergence separately of either F227L or L234I. In the resistance selection of subtype A and C viruses, similar mutation development pathways were detected, in which a V106A or V106M mutant was also the starting virus in the pathways. Mutations that are commonly associated with RPV and EFV in clinical settings were also identified in subtype B viruses such as the E138K and K103N mutants, respectively, in this in vitro resistance selection study. The susceptibility of subtype B mutant viruses selected by DOR, RPV, and EFV to NNRTIs was evaluated. Results suggest that mutant viruses selected by DOR are susceptible to RPV and EFV and mutants selected by RPV and EFV are susceptible to DOR. When the replication capacity of the V106A mutant was compared with that of the wild-type (WT) virus, the mutant virus was 4-fold less fit than the WT virus.
Department of Antiviral Research, Merck Research Laboratories, West Point, Pennsylvania, USA.
Meizhen
M
Feng
Department of Chemistry Modeling & Informatics, Merck Research Laboratories, West Point, Pennsylvania, USA.
Deping
D
Wang
Department of Antiviral Research, Merck Research Laboratories, West Point, Pennsylvania, USA.
Jay A
JA
Grobler
Department of Antiviral Research, Merck Research Laboratories, West Point, Pennsylvania, USA.
Daria J
DJ
Hazuda
Department of Antiviral Research, Merck Research Laboratories, West Point, Pennsylvania, USA.
Michael D
MD
Miller
Department of Antiviral Research, Merck Research Laboratories, West Point, Pennsylvania, USA mingtain_lai@merck.com.
Ming-Tain
MT
Lai
D019380:Anti-HIV Agents / Q000494:pharmacology; D024882:Drug Resistance, Viral / Q000187:drug effects* / Q000235:genetics; D057809:HEK293 Cells / Q000187:drug effects / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics*; D006801:Humans; D009154:Mutation; D009570:Nitriles; D011724:Pyridazines / Q000494:pharmacology; D011728:Pyridones / Q000494:pharmacology*; D011743:Pyrimidines; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology*; D000068696:Rilpivirine / Q000494:pharmacology; D012641:Selection, Genetic; D014230:Triazoles / Q000494:pharmacology*
D019380:Anti-HIV Agents; D009570:Nitriles; D011724:Pyridazines; D011728:Pyridones; D011743:Pyrimidines; D018894:Reverse Transcriptase Inhibitors; D014230:Triazoles; C451734:etravirine; C000592662:doravirine; D000068696:Rilpivirine