Method: Plasma samples contained a median of 3 [Q1-Q3: 2-4] NNRTI-associated drug resistance mutations which included A98G, L100I, K101E/H, K103N/S, V106M, V108I, E138A/K, V179D/E Y181C, Y188L/C, G190A, H221Y, P225H, F227L, and M230L.
Figure: FC resistance was evaluated based on the contribution of the number of RPV-associated mutations (L100I, PMID: 30442114
2018
BMC infectious diseases
Table: H221Y
Short Communication: Discordance in Drug Resistance Mutations Between Blood Plasma and Semen or Rectal Secretions Among Newly Diagnosed HIV-1-Infected Thai Men Who Have Sex with Men.
PMID: 29756454
2018
AIDS research and human retroviruses
Abstract: Three participants had DRAMs in anogenital compartments that were not detected in blood plasma-one had DRAMs in semen that was not detected in blood plasma (I54FI) and two had DRAMs in rectal secretions that was not detected in blood plasma (I47IM; K70N, L74I, Y115F, M184V, K103N, V108I, and H221Y).
Etravirine combined with antiretrovirals other than darunavir/ritonavir for HIV-1-infected, treatment-experienced adults: Week 48 results of a phase IV trial.
Result: The only other NNRTI RAM that emerged in >=5 VFs was H221Y (6/49), which is not an etravirine RAM.
Discussion: The most frequently emerging etravirine RAMs, Y181C, E138A, and M230L (>=5 VFs) have also been observed previously in patients with VF in etravirine trials, as has the only other NNRTI RAM that emerged in >=5 VFs, H221Y.
Polymorphisms and Mutational Covariation Associated with Death in a Prospective Cohort of HIV/AIDS Patients Receiving Long-Term ART in China.
Result: For example, M41L and D67N had 16 (D218E, E44A, G190S, G196E, H221Y, I142V, K101E, L210W, L228R, L74V, M184V, R211K, T215F, V108I, V118I, and V179I) and nine (E44A, H208Y, H221Y, K70R, L210W
HIV-1 drug-resistant mutations and related risk factors among HIV-1-positive individuals experiencing treatment failure in Hebei Province, China.
HIV Drug Resistance Mutations in Non-B Subtypes After Prolonged Virological Failure on NNRTI-Based First-Line Regimens in Sub-Saharan Africa.
PMID: 28129253
2017
Journal of acquired immune deficiency syndromes (1999)
Abstract: In general, DRMs were more common in subtype-C than in subtype-A and/or subtype-D (nucleoside reverse transcriptase inhibitor mutations K65R and Q151M; NNRTI mutations E138A, V106M, Y181C, K101E, and H221Y).
Discussion: The H221Y mutation (conferring rilpivirine resistance and with Y181C possibly etravirine resistance) has been noted in patients with non-B subtypes failing first-line nevirapine or efavirenz-based regimens in a predominantly subtype-G and CRF02 Nigerian cohort and subtype-C South African cohort.
HIV drug resistance in HIV positive individuals under antiretroviral treatment in Shandong Province, China.
Week 48 resistance analysis of Elvitegravir/Cobicistat/Emtricitabine/Tenofovir DF versus Atazanavir + Ritonavir + Emtricitabine/Tenofovir DF in HIV-1 infected women (WAVES study GS-US-236-0128).
Result: Although H221Y has minimal detectable effect on NNRTI susceptibility, it has been found to frequently occur in combination with Y181C in RPV exposed patients.
Result: Four cases of the H221Y (7%.
Result: However, in the present study H221Y was identified only in patients with EFV exposure.
HIV mutation literature information.
PMID: 
2018
Antiviral chemistry & chemotherapy
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