HIVdb version 8.1.1 (last updated 2016-09-23)

PI Resistance Mutation Comments

(NRTI · NNRTI · INSTI)
MutationTypeComment
L10FAccessoryL10F is a common non-polymorphic, PI-selected accessory mutation associated with reduced susceptibility to DRV, FPV, IDV, LPV, and NFV.
L10IVOtherL10I/V are polymorphic, PI-selected accessory mutations that increase the replication of viruses with other PI-resistance mutations.
L10RYOtherL10R/Y are rare, non-polymorphic PI-selected mutations. Their effects on PI susceptibility have not been well studied.
V11ILOtherV11I is a relatively non-polymorphic accessory mutation selected in patients receiving DRV. It is included in the Tibotec genotypic susceptibility score for DRV. V11L is a nonpolymorphic PI-selected mutation associated with reduced DRV and FPV susceptibility when it occurs in combination with other PI-resistance mutations.
K20IOtherK20I is the consensus amino acid in subtype G and CRF02_AG. In subtypes B and C, K20I is a PI-selected accessory mutation that reduces NFV susceptibility.
K20MVOtherK20M/V are rare, relatively non-polymorphic PI-selected mutations that have not been well studied.
K20ROtherK20R is a highly polymorphic PI-selected accessory mutation.
K20TAccessoryK20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to each of the PIs except DRV and TPV.
L23IAccessoryL23I is an uncommon non-polymorphic mutation selected primarily by NFV. It causes low-level NFV resistance.
L24FMAccessoryL24I is a non-polymorphic mutation selected by IDV and LPV. It contributes reduced susceptibility to each PI except DRV and TPV. L24F/M are uncommon non-polymorphic PI-selected mutations. L24F has a susceptibility profile similar to L24I.
L24IAccessoryL24I is a non-polymorphic mutation selected by IDV and LPV. It contributes reduced susceptibility to each PI except DRV and TPV.
D30NMajorD30N is a non-polymorphic mutation that causes high-level resistance to NFV.
V32IMajorV32I is a non-polymorphic PI-selected mutation associated with reduced susceptibility to each of the PIs except SQV. It is included in the Tibotec DRV genotypic susceptibility score.
L33FAccessoryL33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to each of the PIs. It is included in the Tibotec DRV genotypic susceptibility score.
K43TAccessoryK43T is a non-polymorphic PI-selected accessory mutation. K43T is included in the Boehringer-Ingelheim genotypic susceptibility score for TPV.
M46ILMajorM46I/L are relatively non-polymorphic PI-selected mutations. In combination with other PI-resistance mutations, they are associated with reduced susceptibility to each of the PIs except DRV.
M46VAccessoryM46I/L are relatively non-polymorphic PI-selected mutations. In combination with other PI-resistance mutations, they are associated with reduced susceptibility to each of the PsI except DRV. M46V is a rare non-polymorphic PI-selected mutation that has not been well studied.
I47AMajorI47A is a non-polymorphic mutation selected by LPV. It usually occurs in combination with V32I and in this context it confers high-level resistance to LPV and FPV and low/intermediate-resistance to the remaining PIs except ATV and SQV.
I47VMajorI47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to each of the PIs except SQV and ATV. I47V is included in the Tibotec DRV genotypic susceptibility score.
G48ASTQLMajorG48V is a non-polymorphic mutation selected by SQV and, less often, by IDV and LPV. It confers high-level resistance to SQV, intermediate resistance to ATV, and low-level resistance to NFV, IDV and LPV. G48M is a non-polymorphic mutation selected in viruses with multiple PI-resistance mutations. Its effects appear to be similar to those of G48V. G48A/S/T/Q are rare non-polymorphic mutations selected in viruses with multiple PI-resistance mutations.
G48MMajorG48V is a non-polymorphic mutation selected by SQV and, less often, by IDV and LPV. It confers high-level resistance to SQV, intermediate resistance to ATV, and low-level resistance to NFV, IDV and LPV. G48M is a non-polymorphic mutation selected in viruses with multiple PI-resistance mutations. Its effects appear to be similar to those of G48V.
G48VMajorG48V is a non-polymorphic mutation selected by SQV and, less often, by IDV and LPV. It confers high-level resistance to SQV, intermediate resistance to ATV, and low-level resistance to NFV, IDV and LPV.
I50LMajorI50L is a non-polymorphic mutation selected by ATV. It causes high-level resistance to ATV and increases susceptibility to the remaining PIs.
I50VMajorI50V is a non-polymorphic mutation selected by DRV, LPV and FPV. It causes low-level, intermediate, and high-level resistance to DRV, LPV, and FPV, respectively. It is included in the Tibotec DRV genotypic susceptibility score.
F53LAccessoryF53L is a non-polymorphic accessory PI-selected mutation which reduces susceptibility primarily to ATV, SQV, and NFV.
I54ATSMajorI54A/T/S are non-polymorphic PI-selected mutations that occur almost exclusively in viruses with multiple PI-resistance mutations. I54A/T/S are associated with reduced susceptibility to each of the PIs except DRV.
I54LMMajorI54M/L are non-polymorphic mutations selected primarily by DRV and FPV. I54M reduces susceptibility to each of the PIs. I54L reduces susceptibility to each of the PIs except TPV. I54M/L are each included in the Tibotec DRV genotypic susceptibility score.
I54VMajorI54V is a non-polymorphic PI-selected mutation which contributes reduced susceptibility to each of the PIs except DRV.
Q58EAccessoryQ58E is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to TPV and possibly other PIs.
A71ILOtherA71I/L are non-polymorphic, PI-selected accessory mutations that appear to increase the replication of viruses with other PI-resistance mutations.
A71TVOtherA71V/T are polymorphic, PI-selected accessory mutations that increase the replication of viruses with other PI-resistance mutations.
G73STCADVAccessoryG73S/T/C/A are non-polymorphic accessory PI-selected mutations. They are associated primarily with reduced susceptibility to ATV, SQV, IDV, and NFV. G73V/D are rare non-polymorphic PI-selected mutations.
T74PAccessoryT74P is a non-polymorphic PI-selected accessory mutation that occurs primarily in viruses from patients who have received multiple PIs. It is associated with reduced susceptibility to each of the PIs. It is included in the Boehringer-Ingelheim TPV and Tibotec DRV genotypic susceptibility score.
T74SOtherT74S is a PI-selected accessory mutation that is polymorphic in most non-B subtypes.
L76VMajorL76V is a non-polymorphic mutation selected by IDV, LPV and DRV. It reduces susceptibility to these PIs and to FPV and NFV. It increases susceptibility to ATV, SQV and TPV. L76V is included in the Tibotec DRV genotypic susceptibility score.
V82AMajorV82A is a non-polymorphic mutation selected primarily by IDV and LPV. It reduces susceptibility to these PIs and contributes cross-resistance to each of the remaining PIs except DRV and TPV.
V82CMajorV82C is an uncommon non-polymorphic mutation that occurs primarily in viruses with multiple other PI-resistance mutations. Its effects on PI susceptibility have not been well studied.
V82FMajorV82F is a non-polymorphic mutation selected primarily by IDV and LPV. It reduces susceptibility to these PIs and contributes cross-resistance to each of the remaining Pis.
V82IOtherV82I is a highly polymorphic mutation that is not selected by PIs. It is the consensus amino acid in subtype G viruses.
V82LMajorV82L is an uncommon non-polymorphic mutation selected by TPV. It reduces TPV susceptibility but its effects on other PIs have not been well studied.
V82MMajorIn most subtypes, V82M is a 2-base-pair mutation that develops in viruses with multiple other PI-resistance mutations. In subtype G, V82M is a 1-base-pair mutation. V82M reduces susceptibility to IDV, LPV and possibly other PIs.
V82TSMajorV82T/S are non-polymorphic PI-selected mutations. They are associated with reduced susceptibility to each of the PIs except DRV. V82T is included in the Boehringer-Ingelheim TPV genotypic susceptibility score.
N83DAccessoryN83D is a non-polymorphic mutation selected primarily in patients who have received multiple PIs. It is included in the Boehringer-Ingelheim genotypic susceptibility score for TPV.
I84ACMajorI84A is an extremely rare non-polymorphic PI-selected substrate-cleft mutation associated with high-level resistance to each of the PIs. I84C is an extremely rare non-polymorphic PI-selected mutation associated with varying degrees of reduced susceptibility to each of the PIs.
I84VMajorI84V is a non-polymorphic mutation selected by each of the PIs. It causes high-level resistance to ATV, FPV, IDV, NFV and SQV, intermediate resistance to LPV and TPV, and low-level resistance to DRV.
I85VOtherI85V is a non-polymorphic PI-selected mutation. It has minimal, if any, effects on PI susceptibility.
N88DAccessoryN88D is a non-polymorphic mutation selected by NFV usually in combination with D30N. It reduces NFV susceptibility and may cause low-level cross-resistance to ATV and SQV.
N88SMajorN88S is a non-polymorphic mutation usually selected by NFV, ATV, or IDV. It causes high-level resistance to NFV and ATV and low-level resistance to IDV and SQV. It increases susceptibility to FPV.
N88TGMajorN88G/T are extremely rare non-polymorphic PI-selected mutations that reduce susceptibility to NFV and ATV.
L89VTAccessoryL89V is a non-polymorphic PI-selected accessory mutation which contributes reduced susceptibility to FPV and DRV. L89V is included in the Tibotec DRV genotypic susceptibility score. L89T is a rare non-polymorphic PI-selected mutation of uncertain phenotypic and clinical significance.
L90MMajorL90M is a non-polymorphic PI-selected mutation which reduces susceptibility to each of the PIs except TPV and DRV.