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Basic Characteristics of Mutations
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Mutation Site
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K70R |
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Mutation Site Sentence
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The DTG + 3TC cultures had variable combinations of several additional drug-associated mutations comprisedof V75I, V118I, K70R, T215A, and/or K219N/R in RT andP145S, L74M, A128T, and/or G140E in IN. |
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Mutation Level
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Amino acid level |
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Mutation Type
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Nonsynonymous substitution |
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Gene/Protein/Region
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RT |
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Standardized Encoding Gene
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gag-pol:155348
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Genotype/Subtype
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HIV-1 IIIB |
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Viral Reference
|
-
|
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Functional Impact and Mechanisms
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Disease
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HIV Infections
|
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Immune
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- |
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Target Gene
|
-
|
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Clinical and Epidemiological Correlations
|
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Clinical Information
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Y |
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Treatment
|
dolutegravir (DTG);lamivudine (LAM) |
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Location
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- |
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Literature Information
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|
PMID
|
33196554
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Title
|
Simulating HIV Breakthrough and Resistance Development During Variable Adherence to Antiretroviral Treatment
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Author
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Mulato A,Acosta R,Chang S,Martin R,Yant SR,Cihlar T,White K
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Journal
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Journal of acquired immune deficiency syndromes (1999)
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Journal Info
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2021 Mar 1;86(3):369-377
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Abstract
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BACKGROUND: Barriers to lifelong HIV-1 suppression by antiretrovirals include poor adherence and drug resistance; regimens with higher tolerance to missed doses (forgiveness) would be beneficial to patients. To model short-term nonadherence, in vitro experiments monitoring viral breakthrough (VB) and resistance development were conducted. METHODS: HIV breakthrough experiments simulated drug exposures at full adherence or suboptimal adherence to bictegravir+emtricitabine+tenofovir alafenamide (BIC+FTC+TAF) or dolutegravir + lamivudine (DTG+3TC). MT-2 cells were infected with wild-type or low frequency M184V HIV-1, exposed to drug combinations, monitored for VB, and rebound virus was deep sequenced. Drug concentrations were determined using human plasma-free adjusted clinical trough concentrations (Cmin), at simulated Cmin after missing 1 to 3 consecutive doses (Cmin - 1 or Cmin - 2, and Cmin - 3) based on drug or active metabolite half-lives. RESULTS: Cultures infected with wild-type or low frequency M184V HIV-1 showed no VB with BIC+FTC+TAF at drug concentrations corresponding to Cmin, Cmin - 1, or Cmin - 2 but breakthrough did occur in 26 of 36 cultures at Cmin - 3, where the M184V variant emerged in one culture. Experiments using DTG + 3TC prevented most breakthrough at Cmin concentrations (9/60 had breakthrough) but showed more breakthroughs as drug concentrations decreased (up to 36/36) and variants associated with resistance to both drugs emerged in some cases. CONCLUSIONS: These in vitro VB results suggest that the high potency, long half-lives, and antiviral synergy provided by the BIC/FTC/TAF triple therapy regimen may protect from viral rebound and resistance development after short-term lapses in drug adherence.
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Sequence Data
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-
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