TABLE 3.

ARV therapy and virologic response in 22 persons with T215 revertant mutations undergoing UDPS

Patient no., treatment, and response groupYear of sampleCD4 count (cells/μl)HIV-1 RNA (log copies/ml)aDrug resistance mutation(s) (including minority variants)bARVcDescription of virological response and follow-up therapyc,d
Treated, complete virological response (n = 10)
    181619983605.241L (11%), 215Dd4T + ddI + EFVComplete virologic suppression at 54 mo
    393019993905.5215C, 215D (7%)d4T + 3TC + IDVComplete virologic suppression at 18 mo
    526119991904.8215Dd4T + 3TC + EFVComplete virologic suppression at 15 mo
    14661200290>5.7215DA, 215S/E (1%, 1%)ZDV + 3TC + LPV/rComplete virologic suppression at 21 mo
    1640720031335.3215STDF + 3TC + EFVComplete virologic suppression at 34 mo
    183312004176>5.7215SddI + 3TC + EFVComplete virologic suppression at 42 mo
    2500020051705.241L, 215EZDV + 3TC+ ABC + LPV/rComplete virologic suppression at 22 mo
    25685200535>5.741L (2%), 215STDF + FTC + ATV/rComplete virologic suppression at 31 mo
    3019520063905.341L, 215ETDF + FTC + ddI + EFVComplete virologic suppression at 14 mo
    790020006805.5108I, 208Y, 215Cd4T + 3TC + IDV/rComplete virologic suppression at 4 mo; ARVs discontinued
Treated, virological failure (n = 3)
    965020011214.941L, 215Dd4T + ddI +APVComplete virologic suppression at 44 mo; at mo 8 changed to d4T + ddI + EFV; at mo 44, virologic failure with K103N
    164122003745.467N, 70S, 215S, 215C (1%)ZDV + 3TC + NFVVirologic failure with phenotypic 3TC and NFV resistance; follow-up ARV of TDF + DDI + LPV/r, leading to virologic suppression at 60 mo
    301542006765.070R (4%), 75I (1%), 77L (1%), 215ETDF + FTC + EFVVirologic failure on initial and follow-up with TDF + FTC + ATV/r; repeat genotype after second virologic failure detected V75L K103N M184I P225H
Untreated or early discontinuation (n = 9)
    278702004465>5.7215EABC + 3TC + LPV/rPartial virological response; ARVs discontinued after 2 mo
    39210200730>5.7108I (2%), 210W, 215DTDF + FTC + LPV/rLost to follow-up
    2383520044864.341L, 184I (1%), 215SNoneFollowed 39 mo; stable RNA and CD4 values
    2567420053105.0108I (3%), 208Y, 215CNoneFollowed 26 mo; stable RNA and CD4 values
    2642020053954.441L. 67N, 69D, 210LW, 215C, 215S (25%)NoneFollowed 19 mo; stable RNA and CD4 values
    3021520064484.7215SNoneFollowed 15 mo; stable RNA and CD4 values
    279792006486>5.7208Y, 215CNoneFollowed 10 mo; decreasing RNA and stable CD4 values
    3799120066734.4215DNoneFollowed 10 mo; stable CD4 and RNA values
    4211920073635.2215ENoneFollowed 6 mo; stable CD4 and RNA values
  • a Plasma HIV-1 RNA level.

  • b The percentages for the minority variants are shown in parentheses.

  • c 3TC, lamivudine; ABC, abacavir; APV, amprenavir; ATV, atazanavir; d4T, stavudine; ddI, didanosine; EFV, efavirenz; FTC, emtricitabine; IDV, indinavir; LPV, lopinavir; TDF, tenofovir; ZDV, zidovudine; /r, ritonavir provided for pharmacologic boosting. Combined therapies are indicated with a plus sign.

  • d Virologic suppression was defined as persistent plasma HIV-1 RNA levels of <75 copies/ml, the lower limit of quantification of the Siemens bDNA assay.