Deep sequencing of HIV-1 reveals extensive subtype variation and drug resistance after failure of first-line antiretroviral regimens in Nigeria.

This is highlighted by a phenotypic analysis that showed the cytosine analogue mutation M184V mitigates against the effects of K65R, and so the overall impact on tenofovir susceptibility may not be significant when these two mutations coexist. 31 This hypothesis was strengthened by the results of the NADIA trial, which showed that participants with K65R and M184V mutations at baseline were no more likely to fail a regimen containing tenofovir compared with zidovudine, when combined with lamivudine and either darunavir or dolutegravir. 32 Notably, all participants in the present analysis who had the K65R mutation also had M184I/V.

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