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Number of mutations
Feb 22, 2004


I was wondering if anyone has ever quantified the number of possible mutations? Are there common ones and less common ones. Which are the most common mutations?

Response from Dr. Sherer

The International AIDS Society - USA maintains an updated list of clinically significant HIV mutations that can be easily accessed at It was last updated in October, 2003.

The total number is significantly higher than this list, since the replication rate is so high (10 billion events per day) and highly error prone. Some of these may appear on resistance tests as 'polymorphisms' which have no known clinical significance.

There are some worth noting for each class.

For example, many) are affected by 'NAMS' (nucleoside analogue mutatins), at positions 41, 44, 67 70, 118, 210, 215 and 219. Note that polymorphisms can also occur at these loci. Multiple TAMS reduce susceptibility to these drugs. Mutations at the 151 locus, called the 151 complex, and inserted sites at locus 69, called the 69 insertion complex, confer resistance to all NRTIs.

The NNRTIs are affected by mutations at the 103, 106, 181, and 188 loci.

And the protease inhibitors require multiple mutations at numerous sites, among them 10, 32, 46, 54, 82, 84, and 90.

To interpret resistance test results, there is no substitute for talking with your doctor. This information requires careful interpretation along with several other key peices of information, including your drug history, history of adherence to your regimens, and your clinical status.

concerned about cd4 increase with viral increase
once resistant to one drug,

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