{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:14:19Z","timestamp":1790374459293,"version":"4.1.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T00:00:00Z","timestamp":1574812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>M184V\/I cause high-level lamivudine (3TC) and emtricitabine (FTC) resistance and increased tenofovir disoproxil fumarate (TDF) susceptibility. Nonetheless, 3TC and FTC (collectively referred to as XTC) appear to retain modest activity against human immunodeficiency virus-1 with these mutations possibly as a result of reduced replication capacity. In this study, we determined how M184V\/I impacts virus load (VL) in patients failing therapy on a TDF\/XTC plus nonnucleoside reverse-transcriptase inhibitor (NNRTI)-containing regimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared VL in the absence and presence of M184V\/I across studies using random effects meta-analysis. The effect of mutations on virus reverse-transcriptase activity and infectiousness was analyzed in vitro.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>M184I\/V was present in 817 (56.5%) of 1445 individuals with virologic failure (VF). Virus load was similar in individuals with or without M184I\/V (difference in log10 VL, 0.18; 95% confidence interval, .05\u2013.31). CD4 count was lower both at initiation of antiretroviral therapy and at VF in participants who went on to develop M184V\/I. L74I was present in 10.2% of persons with M184V\/I but absent in persons without M184V\/I (P &amp;lt; .0001). In vitro, L74I compensated for defective replication of M184V-mutated virus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Virus loads were similar in persons with and without M184V\/I during VF on a TDF\/XTC\/NNRTI-containing regimen. Therefore, we did not find evidence for a benefit of XTC in the context of first-line failure on this combination.<\/jats:p><\/jats:sec>","DOI":"10.1093\/infdis\/jiz631","type":"journal-article","created":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T12:09:52Z","timestamp":1574770192000},"page":"1108-1116","source":"Crossref","is-referenced-by-count":24,"title":["Human Immunodeficiency Virus-1 Viral Load Is Elevated in Individuals With Reverse-Transcriptase Mutation M184V\/I During Virological Failure of First-Line Antiretroviral Therapy and Is Associated With Compensatory Mutation L74I"],"prefix":"10.1093","volume":"222","author":[{"given":"J","family":"Gregson","sequence":"first","affiliation":[{"name":"Department of Biostatistics, London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S Y","family":"Rhee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford University, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Datir","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, UCL, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Pillay","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, UCL, London, United Kingdom"},{"name":"Africa Health Research Institute, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C F","family":"Perno","sequence":"additional","affiliation":[{"name":"Department of Oncology and Haematoncology, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Derache","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R S","family":"Shafer","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford University, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9751-1808","authenticated-orcid":false,"given":"R K","family":"Gupta","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute, Durban, South Africa"},{"name":"Department of Medicine, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,11,27]]},"reference":[{"key":"2020090100422254800_CIT0001","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/S1473-3099(09)70136-7","article-title":"Virological monitoring and resistance to first-line highly active antiretroviral therapy in adults infected with HIV-1 treated under WHO guidelines: a systematic review and 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