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JAC Advance Access published online on November 25, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh009
© 2003 by The British Society for Antimicrobial Chemotherapy
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© 2003 The British Society for Antimicrobial Chemotherapy

Review

Relationships among various nucleoside resistance-conferring mutations in the reverse transcriptase of HIV-1

Dan Turner 1 , Bluma Brenner 1 , and Mark A. Wainberg 1 *

1 McGill University AIDS Centre, Lady Davis Institute, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, Quebec, Canada H3T 1E2

* Corresponding author. E-mail: mark.wainberg{at}mcgill.ca.

Abstract

Highly active antiretroviral therapy has significantly improved HIV-related morbidity and mortality, and nucleoside reverse transcriptase inhibitors remain an essential component of treatment. However, the emergence of HIV-1 mutated strains that are resistant to one or more antiretroviral drugs is a leading cause of treatment failure among patients living with HIV/AIDS. These resistant strains may often suffer from a replication disadvantage in comparison with wild-type viruses when grown in the absence of drug pressure and a potential benefit in this regard has been shown for lamivudine-resistant viruses that contain a M184V mutation in reverse transcriptase, as well as for several other drug-resistant viral variants. Interactions between different mutations may complicate the understanding of HIV drug resistance with regard to the likelihood of therapeutic success.

Keywords: HIV, NRTIs, resistance, mutations, antiretroviral drugs, nucleosides, diminished sensitivity, viral fitness
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