REVERSE-TRANSCRIPTASE MUTATIONS IN HIV-1-INFECTED CHILDREN TREATED WITH ZIDOVUDINE

Human immunodeficiency virus type 1 (HIV-1) reverse transcriptase (RT) mutations were detected in DNA from peripheral blood mononuclear cell s from II of 12 HIV-1-infected children after 11-20 months of zidovudi ne monotherapy. The number of children with mutations detected at each codon were as follows: codon 41, 4; codon 67, 2; codon 70, 7; codon 2 15, 7; codon 219, 0. Codon 41 mutations were found only in the presenc e of a codon 215 mutation and in the absence of a codon 70 mutation. T he codon 41/215 mutant combination was associated with decline in weig ht-for-age z score during therapy, weight <10th percentile, CD4(+) cel l counts <3rd percentile, and immune-complex dissociated HIV-1 p24 ant igen (ICD p24 Ag) levels >100 pg/ml. Patients developing the codon 70 mutation tended to have body weight >30th percentile, CD4(+) cell coun ts >25th percentile, and ICD p24 Ag <100 pg/ml. The codon 41 mutation was associated with clinical deterioration during a 6-month followup p eriod.