HIV resistance Flashcards
When should resistance testing be performed
Whilst on failing therapy or within 2-4 weeks of discontinuation
What are the most common resistance patterns in those failing first line NNRTI/2NRTI
70% have wild type virus
66% will have NNRTI and 50%NRTI mutations by week 48
What drugs does M184v cause INCREASED susceptibility to
TAF, TDF and zidovudine
What does the M184v mutations worsen susceptibility to
FTC/3TC
Abacavir in the presence of TAMs
What sub type is associated with an increased risk of developing K65R mutation
HIV-1 subtype C
K65R reduced susceptibility to
TDF and ABV 2 fold
3TC and FTC 5-10 fold
K65R increases susceptibility to
AZT (zidovudine) except in combination with Q151M
TAM- 1 pattern
M41L
L210W
T215Y
High level AZT resistance and impact on ABC and TDF
TAM definition
Non polymorphic mutations selected by thymidine analogs AZT and d4T. Reduce susceptibility to NRTIs by facilitating primer unblocking
TAM 2 pattern
D67N
K70R
T215F
K219Q/E
Risk of NNRTI resistance with treatment interruption
12-16%
Most common TDR mutation in NNRTIs
K103N
Is selected by persons receiving NVP and EFV
Does not affect susceptibility to RPV, ETR or DOR
What resistance mutation is selected by those failing RPV
E138K
But this does not reduce susceptibility to NVP,EFV or DOR
Three common Raltegravir resistance mutations
Q148HRK (high level resistance with G140S)
N155H
Y143CR
Dolutegravir resistance
R263K- most common
N155H
Q148HRK
