Failure of initial therapy with two nucleosides and efavirenz is not associated with early emergence of mutations in the C-terminus of HIV-1 reverse transcriptase

J Acquir Immune Defic Syndr. 2011 Apr;56(4):344-8. doi: 10.1097/QAI.0b013e31820cf029.


It is uncertain how often mutations in the connection or RNase H domains of HIV-1 reverse transcriptase (RT) emerge with failure of first-line antiretroviral therapy. Full-length RT sequences in plasma obtained pretherapy and at virologic failure were compared in 53 patients on first-line efavirenz-containing regimens from AIDS Clinical Trials Group study A5142. HIV-1 was mostly subtype B (48 of 53). Mutations in the polymerase but not in connection or RNase H domains of RT increased in frequency between pretherapy and failure (K103N, P = 0.001; M184I/V, P = 0.016). Selection of mutations in C-terminal domains of RT is not common with early failure of efavirenz-containing regimens.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active / methods
  • Benzoxazines / therapeutic use*
  • Drug Resistance, Viral*
  • HIV Infections / drug therapy*
  • HIV Reverse Transcriptase / genetics*
  • HIV-1 / drug effects*
  • HIV-1 / genetics
  • HIV-1 / isolation & purification
  • Humans
  • Mutation, Missense*
  • Nucleosides / therapeutic use*
  • RNA, Viral / genetics
  • Sequence Analysis, DNA


  • Anti-HIV Agents
  • Benzoxazines
  • Nucleosides
  • RNA, Viral
  • reverse transcriptase, Human immunodeficiency virus 1
  • HIV Reverse Transcriptase
  • efavirenz