Drug resistance and virologic response in NUCA 3001, a randomized trial of lamivudine (3TC) versus zidovudine (ZDV) versus ZDV plus 3TC in previously untreated patients

Evolution of HIV Resistance Mutations in Patients Maintained on a Stable Treatment Regimen After Virologic Failure

“…Other studies have shown that 184V is usually the first nucleoside reverse transcriptase inhibitor mutation to arise in failing zidovudine plus lamivudine regimens but have not examined the long-term evolution of TAMs after initial treatment failure. [39][40][41][42][43][44] The relatively gradual rate of accrual of TAMs in patients receiving lamivudine may be related to the observation that in the presence of the 184V mutation, the emergence of TAMs decreases viral fitness as measured by replication capacity. 29 Thus, in the presence of M184V, mutations that diminish nucleoside reverse transcriptase inhibitor activity (TAMs) may not be favored.…”

Randomised trial of addition of lamivudine or lamivudine plus loviride to zidovudine-containing regimens for patients with HIV-1 infection: the CAESAR trial

“…Indeed, in naive patients lamivudine delays the onset of zidovudine-associated mutations. 20,21 In contrast, didanosine or zalcitabine do not appear to delay the onset of zidovudine-associated mutations. 22 Other studies have shown that HIV-1 variants that are resistant to zidovudine regain phenotypic sensitivity to zidovudine in the presence of lamivudine.…”

Successful HIV Treatment

“…Adding lamivudine to the treatment plan causes an initial 1.5 log decline in HIV viral load. 4 Even though HIV can develop resistance to lamivudine, the viral load does not return to baseline in the face of continued lamivudine therapy but is durably suppressed by about 0.5 logs.…”