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Reminder of important clinical lesson
Baseline-transmitted V106V/I/M non-nucleoside reverse transcriptase inhibitor resistance in HIV-1 subtype B infection
  1. Elizabeth Sherman1,2,
  2. Shara Elrod1,2,
  3. Paula Eckardt2
  1. 1Pharmacy Practice, Nova Southeastern University, Fort Lauderdale, Florida, USA
  2. 2South Broward Community Health Services, Memorial Healthcare System, Miramar, Florida, USA
  1. Correspondence to Dr Elizabeth Sherman, esherman{at}


We report a case in which an antiretroviral therapy (ART)-naïve patient diagnosed with HIV-1 subtype B presented with baseline genotype and phenotype resistance tests, confirming a V106V/I/M nucleoside resistance mutation. The V106V/I/M mutation represents a mixture of virus strains conferring resistance to the non-nucleoside reverse transcriptase inhibitor antiretrovirals efavirenz and nevirapine. V106M mutation is not often observed as a primary resistance mutation in patients infected with HIV-1 subtype B. The patient responded well to an ART regimen consisting of tenofovir–emtricitabine and raltegravir, achieving and maintaining an undetectable HIV RNA.

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