Mutations and polymorphisms associated with antiretroviral drugs in HIV-1C-infected African patients

Florence Doualla-Bell, Simane Gaseitsiwe, Thumbi Ndung'u, Musetsanagepe Modukanele, Trevor Peter, Vladimir Novitsky, Ndwapi Ndwapi, Gaolathe Tendani, Ava Avalos, William Wester, Hermann Bussmann, Peter Cardiello, Richard Marlink, Howard Moffat, Ibou Thior, Mark A. Wainberg, Max Essex

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


To detect and characterize polymerase gene (pol) polymorphisms and mutation patterns in HIV-1C-infected Batswana patients treated with reverse transcriptase inhibitors, samples from AIDS patients treated with highly active antiretroviral therapy (HAART) were sequenced for the region encompassing the entire HIV-1 protease (PR) and the first 335 amino acids of reverse transcriptase (RT). Amongst the 16 patients treated with antiretroviral (ARV) drugs, eight started HAART regimens containing didanosine, stavudine and nevirapine (ddl/d4T/NVP) or efavirenz (EFV) (arm A) while the others started with zidovudine (AZT) and lamivudine (3TC) given together as combivir (CBV) with either NVP or EFV as arm B. Arm B is the first line regimen currently provided by the Botswana ARV national programme. Greater efficacy, in terms of treatment duration, was observed in patients in arm B (14 months) as compared with patients in arm A (9 months); P<0.05, n=8. Appearance of the M184V mutation in the arm B patients coincided with a rebound of viral load (VL) (4.3 ±0.1 log10 RNA copies/mi) and a significantly improved immunological parameter (ΔCD4=207.0 ±48.1 cells/μl; P<0.05). Interestingly, patients developing the M184V mutation preferentially harboured polymorphisms Q174K and/or I178L located in close proximity to pol position 184. The M184V mutation occurred following a clear clinical benefit consisting of increased CD4 cell counts and lower plasma viral loads. Primary mutations known to be associated with NNRTI and NRTI resistance for HIV-1B were observed in 10 of the 16 treated patients.

Original languageEnglish (US)
Pages (from-to)189-200
Number of pages12
JournalAntiviral Chemistry and Chemotherapy
Issue number4
StatePublished - Jul 2004
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Drug Discovery
  • Virology


  • Botswana
  • HIV-1C
  • M184V
  • Pol mutations


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