TRANSMISSION OF HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 RESISTANT TO NEVIRAPINE AND ZIDOVUDINE

Human immunodeficiency virus type 1 (HIV-1) resistant to the nonnucleo side reverse transcriptase inhibitor nevirapine and to the nucleoside analogue zidovudine was transmitted from a homosexual man to his sex p artner. The virus source patient had commenced combination zidovudine and nevirapine therapy 2.5 years prior to his partner's primary HIV in fection. He received both therapies for 7 months, then discontinued ne virapine treatment, continuing to receive zidovudine monotherapy for a further 16 months. He had ceased zidovudine therapy 6 months before t he time of his partner's seroconversion. Analysis of major and minor i solates obtained from both patients soon after onset of the recipient' s primary HIV infection illness confirmed that an HIV-1 variant mutant at codons 70, 98, and 181 of the viral reverse transcriptase was tran smitted. This is the first documented case of transmission of HIV-1 re sistant to two antiretroviral compounds.