Evidence map›Paper›PMID 41603872›Full record

ReviewAIDS (London, England)2025

HIV-1 3΄ polypurine tract mutations and integrase inhibitor resistance.

Marley D Bishop, Lixin Xu, Ceejay L Boyce, Paul K Drain, Carey Farquhar, Stephen E Hawes, Lisa M Frenkel, Geoffrey S Gottlieb, Robert A Smith

Abstract readReview
In one paragraph

Review in AIDS (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Marley D BishopSeattle Children's Research Institute, Center for Global Infectious Diseases.
Lixin XuCenter for Emerging and Re-Emerging Infectious Diseases.
Ceejay L BoyceSeattle Children's Research Institute, Center for Global Infectious Diseases.
Paul K DrainDepartment of Epidemiology.
Carey FarquharDepartment of Epidemiology.
Stephen E HawesDepartment of Epidemiology.
Lisa M FrenkelSeattle Children's Research Institute, Center for Global Infectious Diseases.
Geoffrey S GottliebCenter for Emerging and Re-Emerging Infectious Diseases.
Robert A SmithCenter for Emerging and Re-Emerging Infectious Diseases.

Funding

Drug Resistance Genotypic and Phenotypic Correlates of Efavirenz and Dolutegravir based Treatment Outcomes across Non-B HIV-1 subtypesR01AI147309 · NIAID · SEATTLE CHILDREN'S HOSPITAL · PI DRAIN, PAUL K, FRENKEL, LISA M · 2019 to 2023
$4.6M
NIAID NIH HHS R01 AI147309
6 · The paper itself

Abstract

The WHO recommends the use of the integrase strand transfer inhibitor (INSTI) dolutegravir for first-line antiretroviral therapy (ART) in all adults living with HIV infection. Although dolutegravir-based ART is well tolerated and effective, mutations in the integrase-encoding region of HIV-1 pol that confer resistance to dolutegravir can undermine treatment efficacy. An alternative pathway to dolutegravir resistance has also been described involving mutations in the 3΄ polypurine tract (3΄PPT), an RNA sequence element known to be important for retroviral reverse transcription and integration. The possible emergence of dolutegravir resistance mutations outside of integrase carries important ramifications for people receiving INSTI-based interventions. In this review, we assess the state of the literature pertaining to mutations in the 3΄PPT of HIV-1 and the potential of such mutations to confer INSTI resistance. We interpret these findings within the larger background of work that informs our understanding of reverse transcription, integration, and the expression of unintegrated DNA (uDNA) in HIV-1-infected cells. We also discuss technical complications that arise as a result of uDNA expression in culture-based drug susceptibility assays, and critically evaluate the supporting evidence for current models of 3΄PPT mutant replication. We conclude by proposing additional studies to determine the role of the 3΄PPT in clinical HIV-1 drug resistance.

Indexed as

Drug Resistance, ViralHeterocyclic Compounds, 3-RingHIV-1HIV InfectionsHIV IntegraseHIV Integrase InhibitorsMutationDolutegravirHumansOxazinesPiperazinesPyridonesDolutegravirHeterocyclic Compounds, 3-RingHIV IntegraseHIV Integrase InhibitorsOxazinesPiperazinesPyridones3’ polypurine tractantiretroviral therapydrug resistanceHIV-1integrase strand transfer inhibitor

Identifiers

PMID41603872
PMCPMC13676462

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.