Importance of early identification of PrEP breakthrough infections in a generalized HIV epidemic: a case report from a PrEP demonstration project in South Africa.
Abstract: Sequencing confirmed a dominant wild type at month one with dual therapy resistance patterns emerging by month three (M184V
Discussion: Also, the M184V mutation occurs more frequently with dual ART use rather than triple therapy.
Discussion: PrEP-selected resistance (M184V mutation) is strongly selected by FTC and 3TC and emerges rapidly in patients receiving either of these drugs.
Discussion: The M184V mutation virus strain adversely affects viral replicative capacity and is less fit compared to the wild type strain, hence it is less likely to be transmitted during infection.
Discussion: dominant wild type virus at month one) suggest that resistance developed as a result of PrEP use, as one would expect that M184V would be a major population from the outset if it was a transmitted virus.
Switching to Bictegravir/Emtricitabine/Tenofovir Alafenamide (B/F/TAF) From Dolutegravir (DTG)+F/TAF or DTG+F/Tenofovir Disoproxil Fumarate (TDF) in the Presence of Pre-existing NRTI Resistance.
PMID: 32701823
2020
Journal of acquired immune deficiency syndromes (1999)
Abstract: M184V/I was present in 14% (81/565).
Pooled resistance analyses of darunavir once-daily regimens and formulations across 10 clinical studies of treatment-naive and treatment-experienced patients with human immunodeficiency virus-1 infection.
PMID: 32715952
2020
HIV research & clinical practice
Abstract: Among 3317 patients using nucleos(t)ide reverse transcriptase inhibitors (N[t]RTIs; mostly emtricitabine and tenofovir), 13 (0.4%) had >=1 N(t)RTI RAM (10 with M184I/V).
Abstract: Among patients receiving D/C/F/TAF (n = 1949), none had post-baseline darunavir, primary PI, or tenofovir RAMs; only two (0.1%) patients developed an emtricitabine RAM, M184V/I.
Impact of archived M184V/I mutation on the effectiveness of switch to co-formulated elvitegravir, cobicistat, emtricitabine and tenofovir alafenamide among virally suppressed people living with HIV.
PMID: 32737511
2020
The Journal of antimicrobial chemotherapy
Abstract: CONCLUSIONS: Among virally suppressed PLWH, EVG/C/FTC/TAF is effective in maintaining viral suppression at Week 48 despite archived M184V/I mutation with or without TAMs.
Abstract: OBJECTIVES: Real-world experience regarding the effectiveness of co-formulated elvitegravir, cobicistat, emtricitabine and tenofovir alafenamide (EVG/C/FTC/TAF) as a switch regimen is sparse among people living with HIV (PLWH) harbouring the M184V/I mutation with or without thymidine analogue-associated mutations (TAMs).
Abstract: Patients with archived M184V/I mutation (case patients) were matched to controls without M184V/I mutation at a 1:4 ratio.
Abstract: RESULTS: Overall, 100 case patients with the M184V/I mutation were identified, including 6 (6.0%) with PMID: 32804970
2020
PloS one
Abstract: The mutation M184V which confers resistance to NRTI drugs of lamivudine (3TC) and emtricitabine (FTC) was the most common (81%) among NRTI associated mutations followed by K65R (34.5%) which is associated with both tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide fumarate (TAF) resistance.
Method: The typical drugs that were available in public health facilities offering third line ART at the time of the study included the NNRTI etravarine (rilpivarine and doravarine were not yet available) and the NRTIs lamivudine and emtricitabine (for M184V mutations).
Result: Overall, the 10 most common mutations were M184V (81%)
Table: M184V
First case of Dolutegravir and Darunavir/r multi drug-resistant HIV-1 in Cameroon following exposure to Raltegravir: lessons and implications in the era of transition to Dolutegravir-based regimens.
PMID: 32843050
2020
Antimicrobial resistance and infection control
2Conclusion: Pending access to required innovative regimen, a salvage therapy
Conclusion: Detected RAMs were M41L, K70Q, V75I, Q151M, M184V and T215F for NRTI; K103N and V108I for NNRTI; and L10F, K20I, M36I, M46I, I47V, I54L, L63H, L76V, V82S and L89I for PI/r.
Review of Doravirine Resistance Patterns Identified in Participants During Clinical Development.
PMID: 32925358
2020
Journal of acquired immune deficiency syndromes (1999)
Method: Of the 4 participants who discontinued for other reasons and were tested, 1 who discontinued because of nonadherence exhibited viral resistance to DOR (RT V106I, H221Y, and F227C substitutions) and FTC (RT M184V).
Table: M184V
Patterns of acquired HIV-1 drug resistance mutations and predictors of virological failure in Moshi, Northern Tanzania.
Abstract: Y115F and M184V (mutations that confer resistance to NRTIs) dual mutations were detected according to both criteria in a single study participant (2%).
Result: Y115F and M184V PDR mutations that are recognized by both criteria, which confer limited resistance against NRTI drugs (abacavir, emtricitabine, lamivudine), were observed in one patient (1.96%) (Table 2).
Table: M184V
Virologic suppression in patients with a documented M184V/I mutation based on the number of active agents in the antiretroviral regimen.
Abstract: Further studies are needed to determine optimal antiretroviral therapy for patients with the M184V/I mutation.
Abstract: Methods: A retrospective chart review was conducted of 100 treatment-experienced patients harboring the M184V/I mutation seen at an urban HIV clinic.
Abstract: Objectives: The optimal antiretroviral therapy for patients with the M184V/I mutation is not known.
Abstract: Regimens containing less than 3 active agents may maintain virologic suppression in patients with the M184V/I mutation.
Abstract: The primary objective of this study was to determine the efficacy of various antiretroviral therapies in patients with HIV and the M184V/I mutation based on the number of active antiretroviral agents.
ViMRT
HIV mutation literature information.
PMID: 
2020
BMC infectious diseases
