The amino acid change V75T in human immunodeficiency virus type 1 reverse transcriptase confers a low level of 2,3-didehydro-2,3-dideoxythymidine (stavudine, d4T) resistance in vivo and in vitro. Valine 75 is located at the basis of the fingers subdomain of reverse transcriptase between the template contact point and the nucleotide-binding pocket. V75T reverse transcriptase discriminates 3.6-fold d4T 5-triphosphate relative to dTTP, as judged by pre-steady state kinetics of incorporation of a single nucleotide into DNA. In addition, V75T increases the DNA polymerization rate up to 5-fold by facilitating translocation along nucleic acid single-stranded templates. V75T also increases the reverse transcriptase-mediated repair of the d4TMP-terminated DNA by pyrophosphate but not by ATP. The V75T/Y146F double substitution partially suppressed both increases in rate of polymerization and pyrophosphorolysis, indicating that the hydroxyl group of Thr-75 interacts with that of Tyr-146. V75T recombinant virus was 3-4-fold d4T-resistant and 3-fold resistant to phosphonoformic acid relative to wild type, confirming that the pyrophosphate traffic is affected in V75T reverse transcriptase. Thus, in addition to nucleotide selectivity V75T defines a type of amino acid change conferring resistance to nucleoside analogues that links translocation rate to the traffic of pyrophosphate at the reverse transcriptase active site.
Antiretroviral therapy directed against the human immunodeficiency virus (HIV)1 is currently increasing the life expectancy of infected individuals. To replicate in infected cells, HIV relies on reverse transcriptase (RT), an essential RNA-and DNA-dependent DNA polymerase encoded by the viral pol gene (1). RT is a major target for drugs acting as inhibitors of retroviral replication. Because dNTPs are natural substrates for RT, more than 20 nucleoside analogues are currently used in vitro, in clinical trials, and in the clinic to inhibit retroviral replication (2, 3). To act as specific RT inhibitors, nucleoside analogues must be converted into 5Ј-triphosphate nucleosides upon phosphorylation by intracellular nucleoside/nucleotide kinases. Most nucleotide analogues do not possess a 3Ј-OH group required for phosphodiester bond formation during DNA synthesis. Therefore, they act as DNA chain terminators once incorporated into the nascent viral DNA.The efficacy of antiretroviral chemotherapy is limited by at least three factors. First, nucleoside analogues have to cross the cellular membrane to be activated to the 5Ј-triphosphate form by cellular kinases. This series of phosphorylation reactions is generally not efficient enough to produce adequate levels of the active nucleoside 5Ј-triphosphate able to compete efficiently with natural dNTPs. Second, RT incorporates nucleotide analogues with, at best, equal efficiency to that of their natural counterparts, i.e. dTTP for both AZTTP and d4TTP. The consequence of these two points is that retroviral replication is not completely suppressed. Third, mutant viruses esca...