Spectrum of Non-Nucleoside Reverse Transcriptase Inhibitor-Associated Drug Resistance Mutations in Persons Living with HIV-1 Receiving Rilpivirine

EuResist Network

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Abstract

INTRODUCTION: Few data are currently available on the nonnucleoside reverse transcriptase (RT) inhibitors (NNRTI) resistance mutations selected in persons living with HIV-1 (PLWH) who develop virological failure while receiving rilpivirine (RPV).

METHODS: We analyzed pooled HIV-1 RT genotypic data from 280 PLWH in the multicenter EuResist database and 115 PLWH in the Stanford HIV Drug Resistance Database (HIVDB) who received RPV as their only NNRTI.

RESULTS: Among the 395 PLWH receiving RPV, 180 (45.6%) had one or more NNRTI-associated DRMs. Overall, 44 NNRTI-associated DRMs were identified, including 26 that occurred in two or more PLWHs. Seven mutations had a prevalence ≥10% among the 180 PLWH with one or more NNRTI-associated DRM: E138K (32.2%), V90I (25.0%), K101E (17.8%), Y181C (17.2%), E138A (13.9%), H221Y (12.2%), and K103N (10.6%). Y181C was significantly more likely to co-occur with K101E, V179F, H221Y, and M230L. Ten novel non-polymorphic mutations at known NNRTI-associated mutation positions were also identified, usually in just one PLWH: L100F, V108A, T139I, P225S, M230V, Y232C, and T240A/I/M/S.

CONCLUSIONS: Our analysis extends the spectrum of mutations emerging in PLWH receiving RPV. Additional phenotypic characterization of RPV-selected mutations is necessary to better understand their biological and possible clinical significance.

Original languageEnglish
Article number1715
JournalViruses
Volume16
Issue number11
DOIs
Publication statusPublished - 31 Oct 2024

Keywords

  • HIV-1 drug resistance
  • non-nucleoside reverse transcriptase inhibitors
  • rilpivirine
  • Reverse Transcriptase Inhibitors/therapeutic use
  • Humans
  • Middle Aged
  • Anti-HIV Agents/therapeutic use
  • Genotype
  • Male
  • Rilpivirine/therapeutic use
  • HIV Infections/drug therapy
  • Drug Resistance, Viral/genetics
  • HIV-1/genetics
  • Female
  • Adult
  • HIV Reverse Transcriptase/genetics
  • Mutation

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