Table 1.

Secondary resistance mutation patterns associated with Q148HRK

Associated secondary mutationsa	Effects on drug resistance or viral fitness of Q148 mutants
N17S33
N17S + G163R33,56
V54I + E138K + G140A72	Increases resistance to raltegravir and elvitegravir compared to addition of E138K + G140A; increases viral fitness
L63I + L74M + A128T + E138K + V151I72
L74M + G140A73
V79I + G140A + G163R40
E92Q + E138K + M154I33,56
T97A38
T112A + G140S + G163R40	Increases raltegravir resistance compared to addition of G140S + G163R
H114Y + A128T74	Increases elvitegravir resistance
T124A33,56
E138K/A33,40,42,56,72,74–76	Depending on Q148 mutation, increases resistance to raltegravir and elvitegravir; increases viral fitness
E138K + G140A72	Increases resistance to raltegravir and elvitegravir compared to addition of G140A alone; increases viral fitness
E138A + G140S + Y143H40	Increases raltegravir resistance compared to addition of G140S alone
E138K + G140A + S230R72	Increases resistance to raltegravir compared to addition of E138K G140A
E138K + G163R33,56
G140A/S/C33,38–40,42,44,45,49,52,56,73,75–79	Depending on Q148 mutation, increases resistance to raltegravir and elvitegravir; increases viral fitness
G140S + N155H40,77,79
G140S + K156N73
G140S/C + G163R/K33,40,45,53,56
G140S + E170A79
N155H45,77
N155H + E170A79
S147G77
G163R33

Notes:

^aShown are mutation patterns found in the same viral sample during in vitro or in vivo selection using raltegravir or elvitegravir. Mutations present at baseline or containing mixtures by population-based sequencing were excluded. References are given for each pattern of resistance mutations.