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The impact of the M184V substitution in HIV-1 reverse transcriptase on treatment response by V Miller; T Stark; AE Loeliger; JMA Lange is a Medicine article available to read on EtoBox.

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The M184V mutation in the HIV‐1 reverse transcriptase gene is primarily associated with rapid, high‐level lamivudine (3TC) resistance. It has also been observed to arise under selective pressure by abacavir, to which it confers low‐level resistance. Although the development of viral drug resistance remains a major concern in antiretroviral therapy, it is known that some immunological and clinical benefit can still be derived from highly active antiretroviral therapy (HAART) regimens despite resistance‐associated virological failure. This residual benefit on a failing regimen is commonly attributed to the preservation of fitness‐reducing protease inhibitor (PI) resistance mutations under continued drug pressure. However, fitness‐reducing nucleoside reverse transcriptase inhibitor (NRTI) mutations may also contribute to the effect. M184V is both common in the treated population and fitness‐reducing. A number of studies, both of dual nucleoside therapy and HAART, have noted a residual treatment effect for 3TC despite the assumed or observed presence of M184V and high‐level phenotypic resistance. The speed and consistency with which this mutation is selected by 3TC under suboptimal vir

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Author

V Miller; T Stark; AE Loeliger; JMA Lange

Publisher

John Wiley and Sons; Wiley (Blackwell Publishing); Blackwell Publishing Inc.; Wiley (ISSN 1464-2662)

Published

2002

Language

EN

Field

Medicine (Health Sciences)