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M9640658.TXT
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1996-03-04
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Document 0658
DOCN M9640658
TI Multidrug-resistant human immunodeficiency virus type 1 strains
resulting from combination antiretroviral therapy.
DT 9604
AU Iversen AK; Shafer RW; Wehrly K; Winters MA; Mullins JI; Chesebro B;
Merigan TC; Division of Infectious Diseases and Geographic Medicine,
Stanford; University, California 94305, USA.
SO J Virol. 1996 Feb;70(2):1086-90. Unique Identifier : AIDSLINE
MED/96135222
AB Multidrug-resistant human immunodeficiency virus type 1 (HIV-1) strains
with reverse transcriptase (RT) mutations at codons A62-->V, V75-->I,
F77-->L, F116-->Y, and Q151-->M have been reported in patients receiving
combination therapy with zidovudine (AZT) and didanosine (ddI).
Infectious clones with each mutation alone, all five mutations together,
and various combinations of mutations were created by site-directed
mutagenesis. Mutation Q151-->M conferred partial resistance to AZT, ddI,
zalcitibine, and stavudine, whereas a combination of four mutations
conferred increased resistance to AZT, ddI, zalcitibine, and stavudine.
The positions of residues 75, 77, and 151 in the three-dimensional
crystal structure of HIV-1 RT suggest that these residues may affect the
ability of the enzyme to discriminate between deoxynucleoside
triphosphates and nucleoside analog RT inhibitors. Replication
experiments showed that clones with mutation F77-->L but without V75-->I
(HIV-1(77), HIV-1(77,151), and HIV-1(77,116,151) had attenuated growth
compared with that of the original HIV-1NL4-3 strain and strains
containing mutations at both positions 75 and 77 (HIV-1(75,77,151) and
HIV-1(75,77,116,15)). Sequence analysis of viral RNA and proviral DNA
from several patients indicated that RT mutations developed in a
sequential and cumulative pattern over the course of a 2- to 4-year
observation period. The present results suggest that drug resistance and
viral replicative capacity both may play a role in selection of HIV-1 RT
mutations.
DE Animal Antiviral Agents/*PHARMACOLOGY Base Sequence Cell Line
Didanosine/*PHARMACOLOGY Drug Resistance, Microbial/GENETICS Drug
Resistance, Multiple/GENETICS Drug Therapy, Combination DNA Primers
DNA, Viral Hela Cells Human HIV Infections/DRUG THERAPY/*VIROLOGY
HIV-1/*DRUG EFFECTS/ENZYMOLOGY/GENETICS Molecular Sequence Data
Mutagenesis, Site-Directed Reverse Transcriptase
Inhibitors/*PHARMACOLOGY RNA-Directed DNA Polymerase/*GENETICS
Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Virus Replication
Zidovudine/*PHARMACOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).