Essential Data on NRTI DRMs
Last updated on 2016-6-20
Prevalence of NRTI DRMs in ARV-naive and -treated patients and their contributions to reduced NRTI susceptibility
| DRM | HIVDB Score | SDRM | Prevalence (%) | Phenotypic Fold Resistance | ||||
|---|---|---|---|---|---|---|---|---|
| ARV-Naive (n=65026) | ARV-Treated (n=26974) | 3FTC (n=1361) | ABC (n=1267) | AZT (n=1373) | TDF (n=1081) | |||
| M184V | >50 | 3 | 0.3 | 0.5 | ||||
| L74V | 1.0 | 1.5 | 0.3 | 0.6 | ||||
| K65R | 5 | 3 | 0.8 | 2 | ||||
| L74I | 0.8 | 1.2 | 0.8 | 0.8 | ||||
| Q151M | 1.7 | 4 | 5 | 1.1 | ||||
| Y115F | 1.4 | 3 | 4 | 1.7 | ||||
| M184I | >50 | 1.7 | 0.3 | 0.6 | ||||
| V75T | 1.8 | 1.6 | 0.8 | 0.9 | ||||
| T69i | 3 | 5 | 18 | 4 | ||||
| T215Y | 1.5 | 1.8 | 6 | 1.4 | ||||
| T215F | 1.5 | 1.7 | 8 | 1.6 | ||||
| K70R | 1.3 | 1.3 | 5 | 1.7 | ||||
| T69D | 1.1 | 1.0 | 0.8 | 0.9 | ||||
| V75M | 0.9 | 1.3 | 1.4 | 1.1 | ||||
| V75A | NA | NA | NA | NA | ||||
| V75S | NA | NA | NA | NA | ||||
| T69d | NA | NA | NA | NA | ||||
| K65N | NA | NA | NA | NA | ||||
| D67d | NA | NA | NA | NA | ||||
| Q151L | NA | NA | NA | NA | ||||
| K70d | NA | NA | NA | NA | ||||
| S68d | NA | NA | NA | NA | ||||
| T215I | 1.8 | 1.5 | 5 | 1.6 | ||||
| T215S | 0.8 | 0.8 | 0.3 | 0.7 | ||||
| T215C | 0.9 | 1.0 | 1.2 | 0.8 | ||||
| T215V | 1.1 | 1.0 | 1.7 | 1.0 | ||||
| T215D | 1.3 | 0.8 | 0.3 | 0.6 | ||||
| T215N | NA | NA | NA | NA | ||||
| T215A | NA | NA | NA | NA | ||||
| T215E | 2 | 1.1 | 1.2 | 1.3 | ||||
| T215L | NA | NA | NA | NA | ||||
| M41L | 1.1 | 1.1 | 2 | 1.5 | ||||
| D67N | 1.2 | 1.2 | 2 | 1.2 | ||||
| L210W | 1.2 | 1.4 | 4 | 1.6 | ||||
| K70E | 2.0 | 1.1 | 0.2 | 1.0 | ||||
| K70G | 1.4 | 1.2 | 0.3 | 1.1 | ||||
| K70T | 0.1 | 0.9 | 3 | 1.8 | ||||
| K70N | 1.0 | 1.3 | 1.6 | 1.4 | ||||
| K70Q | NA | NA | NA | NA | ||||
| K70S | NA | NA | NA | NA | ||||
| K219Q | 1.1 | 1.0 | 0.9 | 1.0 | ||||
| K219E | 1.0 | 0.9 | 0.4 | 0.8 | ||||
| K219N | 1.2 | 1.1 | 1.1 | 1.0 | ||||
| K219R | 1.8 | 1.6 | 3 | 1.5 | ||||
| D67G | 1.1 | 1.1 | 2 | 1.2 | ||||
| F116Y | 1.1 | 1.0 | 3 | 1.2 | ||||
| F77L | 1.0 | 0.9 | 4 | 1.4 | ||||
| D67E | 1.2 | 1.5 | 1.0 | 1.5 | ||||
| K219W | NA | NA | NA | NA | ||||
| D67S | NA | NA | NA | NA | ||||
| D67H | NA | NA | NA | NA | ||||
| T69G | NA | NA | NA | NA | ||||
| D67T | NA | NA | NA | NA | ||||
| K65E | NA | NA | NA | NA | ||||
| A62V | 0.9 | 1.0 | 1.2 | 1.2 | ||||
| V75I | 1.5 | 1.1 | 1.8 | 0.9 | ||||
- Footnotes:
- HIVDB Score: The highest score for 3TC (lamivudine), ABC (abacavir), AZT (zidovudine), and TDF (tenofovir). The HIVDB scores for 3TC and FTC (emtricitabine) are identical.
- SDRM (Surveillance Drug Resistance Mutation): Nonpolymorphic DRMs that have been used for TDR surveillance (Bennett DE et al. PLoSOne 2009).
- Without Major DRMs: Primary DRMs are more likely to occur without additional DRMs. However, many co-occurring DRMs have primary roles in conferring resistance to different ARVs. For example, several primary NRTI DRMs usually occur in combination with M184V because M184V develops rapidly in patients with virological failure while receiving a 3TC or FTC-containing regimen.
- Phenotypic Fold Resistance: The contribution of each DRM to reduced NRTI susceptibility (fold increase in the NRTI concentration required to inhibit a fixed virus inoculum by 50%) determined using published regression analyses. All results are based on susceptibility tests performed using the PhenoSense assay (Monogram, South San Francisco). The complete dataset used for the regression analyses is downloadable (HIVDB Genotype-Phenotype Dataset, http://hivdb.stanford.edu/cgi-bin/GenoPhenoDS.cgi). Phenotypic data for FTC do not differ significantly from the phenotypic data for 3TC. Red: Large contribution to reduced in vitro susceptibility. Pink: Statistically significant modest contribution to reduced in vitro susceptibility. Negative values indicate contribution to increased in vitro susceptibility.