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Interference between D30N and L90M in selection and development of protease inhibitor-resistant human

Wataru Sugiura1, Zene Matsuda, Yoshiyuki Yokomaku

  • 1AIDS Research Center, National Institute of Infectious Diseases, Musashimurayama, Tokyo 2080011, Japan. wsuguira@nih.go.jp

Insights

The D30N and L90M mutations in human immunodeficiency virus type 1 (HIV-1) protease inhibitors (PIs) appear mutually exclusive. Their co-occurrence is rare and functionally antagonistic, impacting viral processing and infectivity.

Area of Science:

  • Virology
  • Molecular Biology
  • Evolutionary Biology

Background:

  • Protease inhibitor (PI) resistance mutations D30N and L90M are key in human immunodeficiency virus type 1 (HIV-1) treatment failure.
  • D30N is specific to nelfinavir resistance, while L90M confers broader PI resistance.
  • Understanding the evolutionary interplay between these mutations is crucial for optimizing HIV-1 therapy.

Purpose of the Study:

  • To investigate the evolutionary relationships and mutual exclusivity of HIV-1 PI resistance mutations D30N and L90M.
  • To determine the biochemical and functional consequences of these mutations, individually and in combination.

Main Methods:

  • Analysis of mutation acquisition in patients with nelfinavir treatment failure.
  • Examination of evolutionary pathways and co-occurrence in clinical databases.
  • Generation and functional characterization of recombinant HIV-1 viruses with specific mutations.

Main Results:

  • D30N acquisition was suppressed when L90M preexisted, indicating mutual exclusivity.
  • D30N/L90M double mutations were rare and appeared to originate primarily from the D30N lineage.
  • Biochemical assays showed D30N significantly impaired viral precursor protein processing, with D30N/L90M causing severe impairment.

Conclusions:

  • The D30N and L90M mutations exhibit mutual antagonism during HIV-1 evolution.
  • This antagonism is supported by their rarity in clinical settings and functional impairment of viral processing.
  • Findings provide biochemical and functional evidence for the mutually exclusive nature of these key PI resistance mutations.

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