| Mutation |
Comments |
| V179D/E/F |
V179D: Selected by NNRTIs (uncommon), resulting in low-level resistance
to DLV, NVP, and EFV. susceptibility. Greater resistance with V179D +
K103R. Associated with decreased ETR susceptibility in combination with
other ETR mutations. 179E: Low-level resistance to DLV, NVP, and EFV.
179F: Associated with intermediate resistance to NVP and DLV, low-level
resistance to EFV, and decreased ETR susceptibility in combination with
other ETR mutations. Usually occurs in combination with Y181C, resulting
in high-level ETR resistance. |
| Y181C/I/V |
Selected by NVP and DLV, causing resistance to both. Causes only lowlevel
resistance to EFV, but clinical response to EFV unlikely, possibly
because of presence of viral subpopulations with other resistance
mutations. Increases susceptibility to AZT and tenofovir. Associated with
decreased ETR susceptibility in combination with other ETR mutations.
Alone, it causes 5-10 fold decrease in ETR susceptibility. |
| Y188L/H/C |
Y188L: Selected by NVP, DLV, and EFV (uncommon) resulting in highlevel
resistance to NVP and EFV and low-level resistance to DLV. Y188C:
Selected by NVP; causes high-level NVP resistance and low-level EFV and
DLV resistance. Y188H: Low-level NNRTI resistance. Y188L/H/C: Effects
on ETR susceptibility unknown. |
G190S/A/
E/Q |
G190A: Selected by NVP and EFV, causing high-level resistance to NVP and
intermediate resistance to EFV. Associated with decreased ETR
susceptibility in combination with other ETR mutations. Increases DLV
susceptibility (clinical relevance unknown). G190S cause high-level
resistance to NVP and EFV and hypersusceptibility to DRV. Associated with
decreased ETR susceptibility in combination with other ETR mutations.
G190E/Q: Causes high-level resistance to EFV and NVP, low-level resistance
to DLV. Associated with decreased ETR susceptibility in combination with
other ETR mutations. |
| P225H |
Usually occurs with K103N, resulting in further loss of EFV susceptibility. |
| F227L |
Sometimes seen in combination with V106A, resulting in further loss of
NVP susceptibility. |
| M230L |
Selected by NNRTIs (uncommon), resulting in high-level resistance to DLV
and NVP and intermediate resistance to EFV. Not on ETR mutation list
from DUET, but selected in vitro with reduction in ETR susceptibility. |
| P236L |
Selected by DLV (uncommon), resulting in high-level DLV resistance . |
| K238T/N |
Selected by NNRTIs (uncommon), usually in combination with K103N or
other NNRTI mutations. Causes intermediate resistance to DLV and NVP
and low-level resistance to EFV. |
| Y318F |
Selected by NNRTIs (uncommon), resulting in intermediate-to-high-level
DLV resistance and low-to-intermediate NVP resistance. |
TABLE 2-12: