Prevalence of genotypic and phenotypic resistance to anti-retroviral drugs in a cohort of therapy-naive HIV-1 infected US military personnel

Scott A. Wegner*, Stephanie K. Brodine, John R. Mascola, Sybil A. Tasker, Richard A. Shaffer, Monica J. Starkey, Anthony Barile, Gregory J. Martin, Naomi Aronson, Wesley W. Emmons, Kevin Stephan, Stuart Bloor, Johan Vingerhoets, Kurt Hertogs, Brendan Larder

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

114 Scopus citations


Objective: While transmission of drug-resistant HIV-1 has been reported, estimates of prevalence of resistance in drug-naive populations are incomplete. We investigated the prevalence of genotypic mutations and phenotypic antiretroviral resistance in a cohort of HIV-1 infected U.S. military personnel prior to the institution of antiretroviral therapy. Design: Cross-sectional cohort study. Methods: Plasma was obtained from 114 recently HIV-1 infected subjects enrolled in an epidemiological study. Genotypic resistance was determined by consensus sequencing of a PCR product from the HIV-1 pol gene. Sequences were interpreted by a phenotypic-genotypic correlative database. Resistance phenotypes were determined by a recombinant virus cell culture assay. Results: Genotypic mutations and phenotypic resistance were found at a higher than expected frequency. Resistance to non-nucleoside reverse transcriptase inhibitors was most common, with a prevalence of 15% of 95 subjects by genotype and 26% of 91 subjects by phenotype. Genotypic and phenotypic resistance respectively were found in 4% and 8% of subjects for nucleoside reverse transcriptase inhibitors and in 10% and 1% for protease inhibitors. One subject harbored virus with resistance to all three drug classes. Conclusions: A substantial frequency of resistance to antiretroviral drugs was identified in a therapy-naive U.S. cohort. In most cases, the genotypic and phenotypic assays yielded similar results, although the genotypic assay could detect some protease inhibitor resistance-associated mutations in the absence of phenotypic resistance. These data suggest the need for optimization of treatment guidelines based on current estimates of the prevalence of drug resistance in HIV-1 seroconverters. (C) 2000 Lippincott Williams and Wilkins.

Original languageEnglish
Pages (from-to)1009-1015
Number of pages7
Issue number8
StatePublished - 2000


  • Drug resistance
  • Genotype
  • HIV
  • Phenotype


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