Transmission dynamics of the M184V drug resistance mutation in primary HIV infection

J Antimicrob Chemother. 2011 Oct;66(10):2346-9. doi: 10.1093/jac/dkr291. Epub 2011 Jul 12.


Objectives: M184V in HIV-1 reverse transcriptase is among the most common mutations in patients failing antiretroviral therapy but is found only rarely in cases of transmitted drug resistance.

Methods: To investigate this apparent paradox, we developed an allele-specific real-time PCR (AS-PCR) assay to determine the transmission of M184V in newly infected individuals.

Results: M184V transmission may occur to a greater extent than previously thought. Persistence of M184V may commonly involve linkage to other drug resistance mutations. The presence of M184V as a single substitution in newly infected individuals was shown to wane over time, as a likely consequence of reversion and overgrowth by more fit wild-type viruses.

Conclusions: The M184V mutation can be documented in newly infected individuals, and the alternative hypothesis that this substitution might impact on the ability of HIV to be transmitted is unfounded.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-HIV Agents / pharmacology*
  • Drug Resistance, Viral
  • Genotype
  • HIV Infections / drug therapy
  • HIV Infections / virology*
  • HIV Reverse Transcriptase / genetics*
  • HIV-1 / drug effects*
  • HIV-1 / enzymology
  • HIV-1 / genetics*
  • Humans
  • Molecular Sequence Data
  • Mutation
  • Real-Time Polymerase Chain Reaction
  • Reverse Transcriptase Inhibitors / pharmacology


  • Anti-HIV Agents
  • Reverse Transcriptase Inhibitors
  • reverse transcriptase, Human immunodeficiency virus 1
  • HIV Reverse Transcriptase

Associated data

  • GENBANK/EU375800
  • GENBANK/EU375801
  • GENBANK/EU906882
  • GENBANK/EU906883
  • GENBANK/EU906884
  • GENBANK/EU906885
  • GENBANK/EU906886
  • GENBANK/EU906887
  • GENBANK/EU906888
  • GENBANK/EU906889
  • GENBANK/EU906890
  • GENBANK/EU906891
  • GENBANK/EU906892
  • GENBANK/EU906893
  • GENBANK/EU906894
  • GENBANK/EU906895
  • GENBANK/EU906896
  • GENBANK/EU906897
  • GENBANK/EU906898
  • GENBANK/EU906899
  • GENBANK/EU906900
  • GENBANK/EU906901
  • GENBANK/EU906902
  • GENBANK/EU906903
  • GENBANK/EU906904
  • GENBANK/EU906905
  • GENBANK/EU906906
  • GENBANK/EU906907