{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T15:25:13Z","timestamp":1759937113149},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,9,21]],"date-time":"2015-09-21T00:00:00Z","timestamp":1442793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"European Regional Development Fund; Estonian Science Foundation","award":["8004","8415","8856"],"award-info":[{"award-number":["8004","8415","8856"]}]},{"name":"Basic Financing and the Target Financing of Estonian Ministry of Education and Research","award":["SF0180004s12","SF0182726s06"],"award-info":[{"award-number":["SF0180004s12","SF0182726s06"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:label \/><jats:p>HIV\u20101 drug resistance mutations (DRMs) and substitutions were assessed after the failure of the first line non\u2010nucleoside reverse transcriptase inhibitors (NNRTIs)\u2009+\u20092 nucleoside\/nucleotide reverse transcriptase inhibitors (NRTIs) treatment regimens (efavirenz\u2009[EFV]\u2009+\u2009lamivudine[3TC]\u2009+\u2009zidovudine [ZDV] vs. EFV\u2009+\u20093TC\u2009+\u2009ddI) among the HIV\u20101 CRF06_cpx infected subjects in Estonia. HIV\u20101 genomic RNA was sequenced; DRMs and amino acid substitutions were compared in 44 treatment na\u00efve and 45 first\u2010line NNRTI\u2009+\u20092 NRTI treatment failed patients consisting of EFV\u2009+\u20093TC\u2009+\u2009ZDV (<jats:italic>n<\/jats:italic>\u2009=\u200917) and EFV\u2009+\u20093TC\u2009+\u2009didanosine[ddI] (<jats:italic>n<\/jats:italic>\u2009=\u200921) therapy failed sub\u2010populations. At least one DRM was found in 78% of treatment experienced patients. The most common NRTI mutations were M184V (80%), L74V (31%), L74I (17%), K219E (9%), and M184I (9%), NNRTI mutations were K103N (83%), P225H (14%), L100I (11%), and Y188L (11%), reflecting generally the similar pattern of DRMs to that seen in treatment failed subtype B viruses. Sub\u2010population analysis revealed that EFV\u2009+\u20093TC\u2009+\u2009ddI failed patients had more DRMs compared to EFV\u2009+\u20093TC\u2009+\u2009ZDV failed patients, especially the ddI DRM L74IV and several additional NNRTI DRMs. Additionally, CRF06_cpx specific mutation E179V and substitutions R32K, K122E, and V200AE were also detected in treatment experienced population. After the failure of the first\u2010line EFV\u2009+\u20093TC\u2009+\u2009ddI therapy HIV\u20101 CRF06_cpx viruses develop additional NRTI and NNRTI mutations compared to EFV\u2009+\u20093TC\u2009+\u2009ZDV regimen. Therefore the usage of EFV\u2009+\u20093TC\u2009+\u2009ddI in this subtype decreases the options for next regimens containing abacavir, and NNRTI class agents. <jats:bold><jats:italic>J. Med. Virol. 88:???\u2013???, 2016<\/jats:italic>.<\/jats:bold> \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmv.24361","type":"journal-article","created":{"date-parts":[[2015,8,20]],"date-time":"2015-08-20T23:03:24Z","timestamp":1440111804000},"page":"448-454","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence of drug resistance mutations in HAART patients infected with HIV\u20101 CRF06_cpx in Estonia"],"prefix":"10.1002","volume":"88","author":[{"given":"Radko","family":"Avi","sequence":"first","affiliation":[{"name":"Department of Microbiology Faculty of Medicine University of Tartu Tartu Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merit","family":"Pauskar","sequence":"additional","affiliation":[{"name":"Department of Microbiology Faculty of Medicine University of Tartu Tartu 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