<!--#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 90I0000 98G10301015 100I45453060 100V30301015 101E15301530 101P60604560 101Q0000 101H15151010 101N0000 103N606000 103R0000 103S456000 103T156000 103Q0000 103E0000 103H606000 106A456000 106M606000 106I0000 108I101500 138A001015 138K10101030 138Q10101015 138G10101015 138R10101015 179D10101010 179E10101010 179T10101010 179L10101015 179I0000 179F10151515 181C30603030 181I30606060 181V30606060 181S15601515 181F15603030 181G15603030 188C606000 188H306000 188L60601560 188F6030030 190A45601515 190S60601515 190E60604545 190Q60604545 190C60601010 190V60601010 190T60601010 221Y10101010 225H303000 227C30303030 227L153000 230L45603045 230I15301530 234I0000 236L0000 238T306000 238N101000 318F103000 348I101500
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
175
B
4120
C
451
D
126
F
82
G
145
AE
333
AG
76
 
A
475
B
7943
C
3272
D
308
F
176
G
429
AE
934
AG
415
238 K R 0.6     R 0.7 R 62   T 1.2
R 1.2
T 1.9 T 1.4
R 0.7
R 1.1
T 0.7
T 2.5
N 1.9
T 2.2
R 0.5
R 57
T 1.7
S 1.0
T 2.3
N 0.5
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
K238E004780580.00 
K238E>=1046080  
K238E>=0>=11456460.000.159
K238E>=0NVP385330.000.054
K238E>=0EFV314210.000.938
K238E>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
K238I0047805100.00 
K238I>=1046080  
K238I>=0>=11456450.000.542
K238I>=0NVP385320.000.506
K238I>=0EFV31420  
K238I>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
K238N0047805160.00 
K238N>=10460810.001.000
K238N>=0>=114564610.400.000
K238N>=0NVP3853110.200.000
K238N>=0EFV3142130.400.000
K238N>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
K238Q0047805110.00 
K238Q>=1046080  
K238Q>=0>=11456430.000.885
K238Q>=0NVP385310.000.665
K238Q>=0EFV314220.000.421
K238Q>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
K238R004780540478.40 
K238R>=1046082254.800.000
K238R>=0>=1145646004.100.000
K238R>=0NVP385343011.100.000
K238R>=0EFV31421103.500.000
K238R>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
K238S0047805220.00 
K238S>=1046080  
K238S>=0>=114564150.100.023
K238S>=0NVP385380.200.000
K238S>=0EFV314240.100.122
K238S>=0ETR00  
MutationNRTINNRTINumSeqNumMut% Mutantp
K238T0047805240.00 
K238T>=10460860.100.065
K238T>=0>=1145643202.100.000
K238T>=0NVP3853671.700.000
K238T>=0EFV3142712.200.000
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.