Abstract: After prolonged viral escape, mutants of the
N155H pathway are replaced by mutants of the
Q148HKR pathway.
Abstract: The emergence of human immunodeficiency virus type 1 resistance to raltegravir, an
integrase strand transfer inhibitor, follows distinct and independent genetic pathways, among which the
N155H and
Q148HKR pathways are the most frequently encountered in treated patients.
Abstract: This finding likely explains why
N155H can be selected early in the course of RAL resistance evolution in vivo but is later replaced by genotypes that include
Q148HKR.