<!--#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 238


HIVdb Algorithm: Comments & Scores
  • K238R is a common polymorphism that does not reduce NNRTI susceptibility.
  • K238T is a nonpolymorphic mutation selected in patients receiving NVP and EFV. It usually occurs in combination with K103N. It reduces susceptibility to NVP and EFV by about 5-fold. It may also reduce susceptibility to ETR and RPV. K238N is a nonpolymorphic accessory mutation that is also selected by NVP and EFV. It appears to have minimal, if any, effects on NNRTI susceptibility.

MutationEFVNVPETRRPV
K238N101000
K238T306000
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 238 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
330
AG
78
 
A
635
B
10958
C
3765
D
419
F
275
G
874
AE
1679
AG
824
238 K R 0.5     R 0.7 R 64   T 1.4
R 0.9
T 1.4 T 1.4
R 0.7
T 1.8
R 1.0
T 2.0
N 1.2
T 1.3 R 57
T 1.9
S 1.2
T 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
K238E005402280.00 
K238E>=1047610  
K238E>=0>=11988280.000.072
K238E>=0NVP405930.000.041
K238E>=0EFV366210.000.920
K238E>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
K238I0054022100.00 
K238I>=1047610  
K238I>=0>=11988260.000.500
K238I>=0NVP405920.000.454
K238I>=0EFV36620  
K238I>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
K238N0054022180.00 
K238N>=10476110.000.975
K238N>=0>=119882760.300.000
K238N>=0NVP4059120.200.000
K238N>=0EFV3662150.400.000
K238N>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
K238Q0054022110.00 
K238Q>=1047610  
K238Q>=0>=11988290.000.116
K238Q>=0NVP405910.000.701
K238Q>=0EFV366220.000.443
K238Q>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
K238R005402242047.70 
K238R>=1047612284.700.000
K238R>=0>=11988210315.100.000
K238R>=0NVP405944610.900.000
K238R>=0EFV36621263.400.000
K238R>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
K238S0054022380.00 
K238S>=1047610  
K238S>=0>=119882250.100.032
K238S>=0NVP405980.100.013
K238S>=0EFV366240.100.597
K238S>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
K238T0054022290.00 
K238T>=10476160.100.099
K238T>=0>=1198823901.900.000
K238T>=0NVP4059771.800.000
K238T>=0EFV3662822.200.000
K238T>=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 238.
Mutation pattern data is not available for K238.

A complete summary of additional in vitro susceptibility data for viruses with K238 obtained using other assays including the Antivirogram can be found 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.