Characterization of human immunodeficiency viruses resistant to oxathiolane-cytosine nucleosides

Antimicrob Agents Chemother. 1993 Apr;37(4):875-81. doi: 10.1128/AAC.37.4.875.


The (-) enantiomers of 2',3'-dideoxy-5-fluoro-3'-thiacytidine [(-)-FTC] and 2',3'-dideoxy-3'-thiacytidine [(-)-BCH-189] were recently shown to inhibit selectively human immunodeficiency viruses (HIV) and hepatitis B virus in vitro. In the current study, the potential for HIV type 1 (HIV-1) resistance to these compounds was evaluated by serial passage of the virus in human peripheral blood mononuclear cells and MT-2 cells in the presence of increasing drug concentrations. Highly drug-resistant HIV-1 variants dominated the replicating virus population after two or more cycles of infection. The resistant variants were cross-resistant to (-)-FTC, (-)-BCH-189, and their (+) congeners but remained susceptible to 2',3'-dideoxycytidine, 3'-azido-3'-deoxythymidine, 3'-fluoro-3'-deoxythymidine, 2',3'-dideoxyinosine, phosphonoformate, the TIBO compound R82150, and the bis(heteroaryl)piperazine derivative U-87201E. Reverse transcriptase derived from drug-resistant viral particles was 15- to 50-fold less susceptible to the 5'-triphosphates of FTC and BCH-189 compared with enzyme from parental drug-susceptible virus. DNA sequence analysis of the reverse transcriptase gene amplified from resistant viruses consistently identified mutations at codon 184 from Met (ATG) to Val (GTG or GTA) or Ile (ATA). Sequence analysis of amplified reverse transcriptase from a patient who had received (-)-BCH-189 therapy for 4 months demonstrated a mixture of the Met-184-to-Val (GTG) mutation and the parental genotype, indicating that the Met-184 mutation can occur in vivo.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antiviral Agents / pharmacology*
  • Base Sequence
  • Cell Line
  • Cloning, Molecular
  • Dideoxynucleosides / pharmacology*
  • Drug Resistance, Microbial
  • Emtricitabine / analogs & derivatives
  • Gene Amplification
  • HIV Reverse Transcriptase
  • HIV-1 / drug effects*
  • HIV-1 / genetics
  • HIV-1 / physiology
  • Humans
  • Lamivudine
  • Microbial Sensitivity Tests
  • Molecular Sequence Data
  • Moloney murine leukemia virus / drug effects
  • Monocytes / drug effects
  • Monocytes / microbiology
  • Point Mutation
  • Polymerase Chain Reaction
  • Reverse Transcriptase Inhibitors
  • Virus Replication / drug effects
  • Zalcitabine / analogs & derivatives
  • Zalcitabine / pharmacology


  • Antiviral Agents
  • Dideoxynucleosides
  • Reverse Transcriptase Inhibitors
  • Lamivudine
  • Zalcitabine
  • HIV Reverse Transcriptase
  • Emtricitabine
  • Racivir