Minor mutations in HIV protease at baseline and appearance of primary mutation 90M in patients for whom their first protease-inhibitor antiretroviral regimens failed

J Infect Dis. 2004 Jun 1;189(11):1983-7. doi: 10.1086/386307. Epub 2004 May 12.


The association between minor mutations in human immunodeficiency virus (HIV) protease at baseline and development of common primary mutation 90M at virological failure (conferring some resistance to all protease inhibitors [PIs]) was evaluated in 93 previously drug-naive patients experiencing failure of their first PI-based antiretroviral regimens. In logistic regression analysis, the probability of accumulating a new 90M mutation at virological failure was associated with the presence at baseline of minor mutation 36I (naturally occurring in approximately 25% of HIV clade B and in >80% of HIV non-clade-B viruses) (adjusted odds ratio, 13.5 [95% confidence interval, 1.89-95.6]; P=.009) and, possibly, of 10I/V. This suggests a potential role for the presence of 36I at baseline in predicting the appearance of 90M at virological failure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiretroviral Therapy, Highly Active*
  • Cohort Studies
  • Drug Resistance, Viral / genetics
  • Female
  • HIV / enzymology*
  • HIV / genetics
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • HIV Protease / genetics*
  • HIV Protease / metabolism
  • HIV Protease Inhibitors / pharmacology*
  • HIV Protease Inhibitors / therapeutic use
  • Humans
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Point Mutation
  • RNA, Viral / chemistry
  • RNA, Viral / genetics
  • Reverse Transcriptase Inhibitors / pharmacology*
  • Reverse Transcriptase Inhibitors / therapeutic use
  • Reverse Transcriptase Polymerase Chain Reaction
  • Sequence Analysis, DNA


  • HIV Protease Inhibitors
  • RNA, Viral
  • Reverse Transcriptase Inhibitors
  • HIV Protease