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During zidovudine therapy, human immunodeficiency virus type 1 (HIV-1) acquires a distinctive set of mutations that diminish the sensitivity of the virus to this drug in vitro. An AIDS patient is described who, while being treated with zidovudine, transmitted HIV-1 bearing a drug resistance mutation to a young woman who had never received zidovudine treatment. DNA sequencing of HIV-1 proviruses confirmed that these 2 persons shared HIV genetic variants, including a mutation at codon 70 in the reverse transcriptase gene associated with reduced in vitro sensitivity to zidovudine. This mutation persisted in the woman > 1 year in the absence of antiretroviral therapy. HIV-1 with genetic markers of zidovudine resistance can be transmitted heterosexually, but it is uncertain whether dissemination of drug-resistant virus will substantially reduce the usefulness of this drug.

Original publication

DOI

10.1093/infdis/169.2.411

Type

Journal article

Journal

J Infect Dis

Publication Date

02/1994

Volume

169

Pages

411 - 415

Keywords

Adult, Base Sequence, DNA Primers, Drug Resistance, Microbial, Female, Genetic Variation, HIV Infections, HIV Reverse Transcriptase, HIV-1, Humans, Male, Molecular Sequence Data, Point Mutation, Polymerase Chain Reaction, RNA-Directed DNA Polymerase, Sexual Behavior, Time Factors, Zidovudine