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Prevalence of key resistance mutations K65R, K103N, and M184V as minority HIV-1 variants in chronically HIV-1 infected, treatment-naïve patients.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author Metzner Karin J, Rauch Pia, Braun Patrick, Knechten Heribert, Ehret Robert, Korn Klaus, Kaiser Rolf, Sichtig Nadine, Ranneberg Britta, van Lunzen Jan, Walter Hauke,
Project Minority quasispecies of drug-resistant HIV-1: Emergence, transmission, dynamics, and clinical relevance in acute and chronic HIV-1 infection
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Original article (peer-reviewed)

Journal Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology
Volume (Issue) 50(2)
Page(s) 156 - 61
Title of proceedings Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology
DOI 10.1016/j.jcv.2010.10.001


BACKGROUND AND OBJECTIVES Minority drug-resistant HIV-1 variants, undetected by conventional genotyping, may impair the outcome of antiretroviral therapy (ART). Thus, we retrospectively analyzed the prevalence of minority drug-resistant HIV-1 variants before ART in chronically HIV-1 infected patients initiating first-line therapy and assessed the impact on clinical outcome in the prospective German Truvada cohort. STUDY DESIGN Samples from 146 antiretroviral treatment-naïve patients were collected between April 2005 and August 2006. K65R, K103N, and M184V variants at low frequencies were detected by allele-specific real-time PCR. RESULTS Minority drug-resistant HIV-1 variants were detected in 20/146 patients (13.7%): the M184V mutation in 12/146 patients (8.2%), the K103N mutation in 8/146 patients (5.5%), and the K65R mutation in 4/146 patients (2.7%). Four patients with the M184V mutation also harbored the K65R or the K103N mutation. The 12- and 24 months virological efficacy data revealed that the rate of treatment failure was not increased in the group of patients harboring minority drug-resistant HIV-1 variants prior to ART. CONCLUSIONS Minority drug-resistant HIV-1 variants can be frequently detected in treatment-naïve, chronically HIV-1 infected patients. Despite the presence of those mutations as minority variants before initiating ART, most of the patients were successfully treated.