HIV: resistant mutations (NRTI)

Mini-review of three high yield NRTI mutations from rounds today — Keep scrolling for more!

lights alphabet GIF


🧬🧬M184V🧬🧬

💠selected by Emtricitabine (FTC), Lamivudine (3TC)
💠High resistance to: FTC/3TC
⬇️viral fitness
⬆️susceptibility tenofovir (TDF/TAF), zidovudine (AZT)

💠Pt may stay on FTC or 3TC with M184V in order to maintain ⬇️fitness + hypersusceptibility to TAF/TDF


🧬🧬K65R🧬🧬
💠selected by TDF/TAF
💠High resistance to tenofovir; cross-class resistance except for AZT
⬆️AZT susceptibility
⬇️viral fitness*

*additive with M184C

🧬🧬TAMs (thymidine analogue mutations)🧬🧬
💠2 pathways
(1) M41L, L210W, T215F/Y
(2) D67N, K70R, K219Q

💠selected by AZT, Stavudine (d4T)
⬇️all NRTIs. Type 1 has greater impact on tenofovir

Halter Beyin GIF

Originally tweeted by BIDMC Infectious Diseases Fellowship (@BIDMC_IDFellows) on 10 June, 2020.

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