<!--#if expr="$title" --> <!--#echo var="title" --> <!--#else --> HIV Drug Resistance Database <!--#endif -->
Stanford University HIV Drug Resistance Database - A curated public database designed to represent, store, and analyze the divergent forms of data underlying HIV drug resistance.

MARVEL on RT mutations at position 230


HIVdb Algorithm: Comments & Scores
  • M230I is an extremely rare mutation selected in vitro by RPV. Its effects on NNRTI susceptibility have not been well studied.
  • M230L is an uncommon nonpolymorphic mutation selected in patients receiving EFV, NVP, and RPV. It causes intermediate to high-level resistance to each of the NNRTIs.

MutationEFVNVPETRRPV
M230I15301530
M230L45603045
Footnote:Mutation scores on the left are derived from published literature linking mutations and ARVs (the complete details can be found in the HIVdb Release Notes).
Genotype-treatment correlation
Mutation frequency according to subtype and drug-class experience.
The frequency of each mutation at position 230 according to subtype and drug-class experience. Data are shown for the 8 most common subtypes. The number of persons in each subtype/treatment category is shown beneath the subtype. Mutations occurring at a frequency >0.5% are shown. Each mutation is also a hyper-link to a separate web page with information on each isolate, including literature references with PubMed abstracts, the GenBank accession number, and complete sequence and treatment records.

PosWTNRTI (but no NNRTI) Treated Persons NNRTI Treated Persons
A
205
B
4133
C
551
D
127
F
82
G
146
AE
325
AG
78
 
A
635
B
10956
C
3765
D
418
F
275
G
874
AE
1636
AG
823
230 M          L 0.8 L 0.8 L 3.3 L 1.5 L 1.1 L 1.0 L 3.0 L 2.5
Footnote: The query page Mutation Prevalence According to Subtype and Treatment to examine the frequency of all mutations according to subtype and treatment; The program HIVSeq provides similar output for mutations in user-submitted sequences; A complete description of the program that generates these tables can be found at Rhee et al AIDS 2006.
 

Mutation frequency according to treatment with individual ARVs.
The first row shows the frequency of the mutation in persons who are RTI-naive (indicated in green). The second row shows the frequency of the mutation in persons who have received one or more NRTIs (No NNRTIs). The third row shows the frequency of the mutation in persons who have received one or more NNRTIs (+/- NRTIs). The following rows show the frequency of the mutation in persons who have received only a single NNRTI. Mutation rates that differ significantly between treated and untreated isolates are indicated in yellow.
MutationNRTINNRTINumSeqNumMut% Mutantp
M230I0057053220.00 
M230I>=10502230.000.726
M230I>=0>=120282210.100.001
M230I>=0NVP419620.000.906
M230I>=0EFV37470  
M230I>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
M230L0057053110.00 
M230L>=10502260.100.000
M230L>=0>=1202823271.600.000
M230L>=0NVP4196751.700.000
M230L>=0EFV37471333.500.000
M230L>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
M230R0057053190.00 
M230R>=1050220  
M230R>=0>=12028230.000.271
M230R>=0NVP41960  
M230R>=0EFV374720.000.852
M230R>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
M230V0057053250.00 
M230V>=10502260.100.049
M230V>=0>=12028280.000.950
M230V>=0NVP419610.000.827
M230V>=0EFV374720.000.896
M230V>=0ETR00  
Footnote: About one-half of the untreated isolates belong to non-subtype B isolates; About 20% of the treated isolates belong to non-subtype B isolates; A page containing summaries for all of the mutations at this position can be found here.

Genotype-phenotype correlation
Phenotypes of top 10 common patterns of drug resistance mutations with mutations at position 230.
Mutation patterns are listed in the frequency with which they have been reported in the published literature. The median level of fold resistance (compared with wildtype) for viruses with the mutation pattern in the first column are indicated when available. The subscripts indicate the number of viruses that were phenotyped. The drug susceptibility assay used was the PhenoSense assay (Monogram, South San Francisco). A hyperlink for each individual pattern is provided to access a complete list of mutations and fold resistances for each sequence matching the pattern of mutation.

A complete summary of additional in vitro susceptibility data for viruses with M230 obtained using other assays including the Antivirogram can be found here. A complete list of all mutation patterns with M230 (not just the top 10 most frequent patterns) can be found at this page.

Mutation PatternsNumber of
Sequences
NVP
foldn
EFV
foldn
ETR
foldn
103N,230L24620011200113.85
230L532549.84211
106M,230L30   
181C,230L2920038.938.71
190A,230L22   
103N,181C,230L17200220021502
100I,103N,230L8   
101E,181C,230L71732232722
103N,106M,230L6   
100I,230L6200120015.81
Footnote: Mutation patterns were defined by the presence or absence of major NNRTI drug resistance mutations ; Sequences containing a mixture at a major drug resistance positions were excluded; For the cutoffs defined by PhenoSense, open the sample report form provided on this page; The full list of all mutation patterns are also available here.

 

Phenotypic coefficients using machine learning
Least Square Regression (LSR) was used to learn the relative contribution of each mutation to the fold decrease in susceptibility for an ARV. The figure on the left (click to enlarge the figure) shows the regression coefficients (which correlate with the contribution to resistance) for the 24 nonpolymorphic NNRTI-resistance mutations shown to contribute decreased susceptibility to at least one NNRTI. A complete description of the method that generates this figure can be found at Rhee et al PNAS 2006.