Minor mutations in HIV protease at baseline and appearance of primary mutation 90M in patients for whom their first protease-inhibitor ntiretroviral regimens failed

The association between minor mutations in human immunodeficiency
virus (HIV) protease at baseline and development
of common primary mutation 90M at virological failure (conferring
some resistance to all protease inhibitors [PIs]) was
evaluated in 93 previously drug-naive patients experiencing
failure of their first PI-based antiretroviral regimens. In logistic
regression analysis, the probability of accumulating a new 90M
mutation at virological failure was associated with the presence
at baseline of minor mutation 36I (naturally occurring in
∼25% of HIV clade B and in >80% of HIV non-clade-B viruses)
(adjusted odds ratio, 13.5 [95% confidence interval, 1.89–95.6];P=.009) and, possibly, of 10I/V. This suggests a potential role
for the presence of 36I at baseline in predicting the appearance
of 90M at virological failure.