The M184I/V and K65R nucleoside resistance mutations in HIV-1 prevent the emergence of resistance mutations against dolutegravir. 2016

Maureen Oliveira, and Ruxandra I Ibanescu, and Hanh Thi Pham, and Bluma Brenner, and Thibault Mesplède, and Mark A Wainberg
aMcGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital bDivision of Experimental Medicine cDepartment of Microbiology and Immunology, Faculty of Medicine, McGill University, Montréal, Québec, Canada.

Recommended treatments for newly diagnosed HIV-positive individuals now focus on the integrase strand transfer inhibitors, raltegravir (RAL), elvitegravir (EVG) and dolutegravir (DTG). In treatment-naive individuals, cases of RAL-based and EVG-based virological failure, although rare, are associated with the occurrence of resistance mutations in integrase and/or reverse transcriptase coding sequences. In such cases, common resistance substitutions in reverse transcriptase that were associated with nucleos(t)ide reverse transcriptase inhibitors included M184I/V and K65R and these occurred together with various mutations in integrase. In some instances, these mutations in reverse transcriptase preceded the emergence of mutations in integrase. In contrast, no resistance substitutions in either integrase or reverse transcriptase have been observed to date in viruses isolated from treatment-naive individuals who experienced treatment failure with DTG-based regimens. The objective of this study was to determine the effects of the M184I/V and K65R substitutions in reverse transcriptase on the ability of HIV-1 to become resistant against RAL, EVG or DTG. We performed tissue culture selection experiments using reverse transcriptase inhibitor-resistant viruses containing resistance substitutions at positions K65R, M184I or M184V in the presence of increasing concentrations of RAL, EVG or DTG and monitored changes in integrase sequences by genotyping. Selections using EVG and RAL led to the emergence of resistance mutations in integrase. In contrast, only the wild-type virus was able to acquire resistance mutations for DTG. Resistance mutations against nucleos(t)ide reverse transcriptase inhibitors antagonized the development of HIV-1 resistance against DTG but not RAL or EVG.

UI MeSH Term Description Entries
D010078 Oxazines Six-membered heterocycles containing an oxygen and a nitrogen.
D010879 Piperazines Compounds that are derived from PIPERAZINE.
D011728 Pyridones Pyridine derivatives with one or more keto groups on the ring. Pyridinones
D006575 Heterocyclic Compounds, 3-Ring A class of heterocyclic compounds that include a three-ring fused structure. Both aromatic or non-aromatic ring structures are included in this category. Fused Heterocyclic Compounds, Three-Ring,Heterocyclic Cpds, 3 Ring,Three Ring Heterocyclic Compounds,3-Ring Heterocyclic Compounds,Fused Heterocyclic Compounds, Three Ring,Heterocyclic Compounds, 3 Ring
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012641 Selection, Genetic Differential and non-random reproduction of different genotypes, operating to alter the gene frequencies within a population. Natural Selection,Genetic Selection,Selection, Natural
D014776 Virus Cultivation Process of growing viruses in live animals, plants, or cultured cells. Viral Cultivation,Cultivation, Viral,Cultivation, Virus,Cultivations, Viral,Cultivations, Virus,Viral Cultivations,Virus Cultivations
D015497 HIV-1 The type species of LENTIVIRUS and the etiologic agent of AIDS. It is characterized by its cytopathic effect and affinity for the T4-lymphocyte. Human immunodeficiency virus 1,HIV-I,Human Immunodeficiency Virus Type 1,Immunodeficiency Virus Type 1, Human
D054303 HIV Reverse Transcriptase A reverse transcriptase encoded by the POL GENE of HIV. It is a heterodimer of 66 kDa and 51 kDa subunits that are derived from a common precursor protein. The heterodimer also includes an RNAse H activity (RIBONUCLEASE H, HUMAN IMMUNODEFICIENCY VIRUS) that plays an essential role the viral replication process. Reverse Transcriptase, HIV,Reverse Transcriptase, Human Immunodeficiency Virus,Transcriptase, HIV Reverse
D060005 Genotyping Techniques Methods used to determine individuals' specific ALLELES or SNPS (single nucleotide polymorphisms). Genotype Assignment Methodology,Genotype Calling Methods,Genotype Determination Methods,Assignment Methodologies, Genotype,Assignment Methodology, Genotype,Calling Method, Genotype,Calling Methods, Genotype,Determination Method, Genotype,Determination Methods, Genotype,Genotype Assignment Methodologies,Genotype Calling Method,Genotype Determination Method,Genotyping Technique,Method, Genotype Calling,Method, Genotype Determination,Methodologies, Genotype Assignment,Methodology, Genotype Assignment,Methods, Genotype Calling,Methods, Genotype Determination,Technique, Genotyping,Techniques, Genotyping

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