Rapid changes in human immunodeficiency virus type 1 rna load and appearance of drug-resistant virus populations in persons treated with lamivudine (3tc)

Rob Schuurman, Monique Nijhuis, Remko Van Leeuwen, Pauline Schipper, Dorien De Jong, Phil Collis, Sven A. Danner, John Mulder, Clive Loveday, Cindy Christopherson, Shirley Kwok, John Sninsky, Charles A.B. Boucher*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The effect of the appearance of drug-resistant human immunodeficiency virus type 1 (HIV-1) on viral RNA load was studied in patients treated with the reverse transcriptase inhibitor lamivudine. During the first 12 weeks of treatment, HIV-I RNA concentrations and amino acid changes in codon 184, causing high-level resistance to lamivudine, were determined in longitudinal serum samples from HIV-1 p24 antigen-positive and -negative patients. A marked decline in the amount of HIV-I RNA (95% below baseline) and HIV-I p24 antigen was observed within 2 weeks, followed by a rise that coincided with the appearance of lamivudine-resistant viruses in serum (isoleucine mutants initially, which were subsequently replaced by valine variants). After 12 weeks, a partial antiviral effect was observed despite the presence of a complete codon 184 mutant virus population in serum. This study shows that the rapid appearance of drug-resistant virus in serum is followed by an increase in viral RNA load.

Original languageEnglish
Pages (from-to)1411-1419
Number of pages9
JournalJournal of Infectious Diseases
Issue number6
Publication statusPublished - Jun 1995

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