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We therefore genotyped the Gag and protease genes from 20 HIV-1 subtype C-infected pediatric patients failing a PI-based regimen. Major protease resistance mutations (M46I, I54V, and V82A) were identified in eight (40%) patients, as well as Gag cleavage site (CS) mutations (at codons 373, 374, 378, 428, 431, 449, 451, and 453) in nine (45%) patients. Four of these Gag CS mutations occurred in the absence of major protease mutations at PI failure. In addition, amino acid changes were noted at Gag non-CS with some predicted to be under HLA\/KIR immune-mediated pressure and\/or drug selection pressure. Changes in Gag during PI failure therefore warrant further investigation of the Gag gene and its role in PI failure in HIV-1 subtype C infection.<\/jats:p>","DOI":"10.1089\/aid.2014.0349","type":"journal-article","created":{"date-parts":[[2015,4,28]],"date-time":"2015-04-28T13:02:00Z","timestamp":1430226120000},"page":"776-782","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Genetic Changes in HIV-1 Gag-Protease Associated with Protease Inhibitor-Based Therapy Failure in Pediatric Patients"],"prefix":"10.1177","volume":"31","author":[{"given":"Jennifer","family":"Giandhari","sequence":"first","affiliation":[{"name":"National Institute for Communicable Diseases (NICD)","place":["South Africa"]},{"name":"University of Witwatersrand","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriaan E.","family":"Basson","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases (NICD)","place":["South Africa"]},{"name":"University of Witwatersrand","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashraf","family":"Coovadia","sequence":"additional","affiliation":[{"name":"University of Witwatersrand","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Kuhn","sequence":"additional","affiliation":[{"name":"Columbia University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaine J.","family":"Abrams","sequence":"additional","affiliation":[{"name":"Columbia University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renate","family":"Strehlau","sequence":"additional","affiliation":[{"name":"University of Witwatersrand","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn","family":"Morris","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases (NICD)","place":["South Africa"]},{"name":"University of Witwatersrand","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gillian M.","family":"Hunt","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases (NICD)","place":["South Africa"]},{"name":"University of Witwatersrand","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,8,1]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"UNAIDS. 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