J Korean Soc Microbiol.
2000 Apr;35(2):181-190.
Detection of resistance mutation to lamivudine in HIV-1 infected patients
Abstract
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To investigate resistance to lamivudine (3TC), we examined the
incidence of M184V in 20 HIV-1 patients treated with 3TC for 13.1 +/- 9
months. Fourteen of 20 patients had been exposed to zidovudine (ZDV) or
didanosine (ddl) prior to 3TC therapy. Nested PCR targeting to reverse
transcriptase (RT) and direct sequencing were performed for peripheral
blood mononuclear cells sampled serially. There were resistance mutations
to ZDV in at least 9 patients at baseline, although there was no
resistance mutation to 3TC. We could detect M184V in 6 (30%) out of 20
patients. The incidence of M184V increased as the duration of therapy
prolongs (13% in samples<12 months; 47% in samples gtoreq 12 months).
The frequency of mutation M184V was higher in patients with previous
mutation to ZDV than in patients with wild type. Resistance mutation was
not detected in 7 patients. This study shows that resistance to 3TC tends
to develop rapidly in patients with baseline mutations or two drugs
combination therapy than in those treated simultaneously with triple
drugs. This report is the first on resistance to 3TC in Korean AIDS
patients.