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Review

Treatment Management Challenges in Naïve and Experienced HIV-1-Infected Individuals Carrying the M184V Mutation

by
Iordanis Mimtsoudis
1,
Olga Tsachouridou
1,*,
Karolina Akinosoglou
2 and
Symeon Metallidis
1
1
Infectious Diseases Division 1st Internal Medicine Department, AHEPA University Hospital Thessaloniki, 54636 Thessaloniki, Greece
2
Department of Internal Medicine and Infectious Diseases, University General Hospital of Patras, 26504 Patras, Greece
*
Author to whom correspondence should be addressed.
Viruses 2024, 16(9), 1392; https://doi.org/10.3390/v16091392
Submission received: 19 May 2024 / Revised: 12 August 2024 / Accepted: 22 August 2024 / Published: 30 August 2024

Abstract

M184V is a single-base mutation in the YMDD domain of reverse transcriptase (RT). The M184V resistance-associated mutation (RAM) is related to virological unresponsiveness to lamivudine (3TC) and emtricitabine (FTC) and induces high-level resistance to these two antiretroviral agents. M184V is rapidly selected in the setting of non-suppressive antiretroviral therapy (ART) and accumulates in the HIV reservoir. There were continuous efforts to evaluate the impact of the M184V mutation on the treatment outcomes in people living with HIV (PLWH). Since 3TC remains an extensively used part of recommended antiretroviral combinations, M184V is commonly detected in patients with virological failure (VF). ART guidelines do not recommend the use of drugs impacted by RAMs as they have been confirmed to comprise a risk factor for VF. However, there is evidence that 3TC/FTC can remain active even in the presence of M184V. Given the potential benefits of 3TC in ART combinations, the investigation of M184V remains of high interest to clinicians and researchers, especially in certain regions with limited resources, and especially for its unusual effects. This is a review of the literature on the challenges in treating both naïve and experienced individuals carrying the M184V mutation, including virological failure, virological suppression, and resistance to ART.
Keywords: HIV-1; drug resistance; M184V; mutation; naïve; experienced HIV-1; drug resistance; M184V; mutation; naïve; experienced

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MDPI and ACS Style

Mimtsoudis, I.; Tsachouridou, O.; Akinosoglou, K.; Metallidis, S. Treatment Management Challenges in Naïve and Experienced HIV-1-Infected Individuals Carrying the M184V Mutation. Viruses 2024, 16, 1392. https://doi.org/10.3390/v16091392

AMA Style

Mimtsoudis I, Tsachouridou O, Akinosoglou K, Metallidis S. Treatment Management Challenges in Naïve and Experienced HIV-1-Infected Individuals Carrying the M184V Mutation. Viruses. 2024; 16(9):1392. https://doi.org/10.3390/v16091392

Chicago/Turabian Style

Mimtsoudis, Iordanis, Olga Tsachouridou, Karolina Akinosoglou, and Symeon Metallidis. 2024. "Treatment Management Challenges in Naïve and Experienced HIV-1-Infected Individuals Carrying the M184V Mutation" Viruses 16, no. 9: 1392. https://doi.org/10.3390/v16091392

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