Peptide insertions in reverse transcriptase pol gene of human immunodeficiency virus type 1 as a rare cause of persistent antiretroviral therapeutic failure  Véronique Schneider, Jérôme Legoff, Laurent Bélec, Nathalie Delphin, Corinne Dutreuil, Ali Kara-Mostefa, Willy Rozenbaum, Jean- Claude Nicolas  Clinical Microbiology and Infection  Volume 10, Issue 2, Pages 127-136 (February 2004) DOI: 10.1111/j.1198-743x.2003.00864.x Copyright © 2004 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 1 Schematic representation of treatment history and codons 67–71 of the RT pol gene for 11 patients whose HIV-1 variants had peptide rearrangements. Black circles depict nucleoside reverse transcriptase inhibitor; black triangles depict non-nucleoside reverse transcriptase inhibitor; black squares depict protease inhibitor. Antiretroviral drug regimens are shown in detail in Table 1. Vertical lines indicate therapeutic shift. Open circles indicate strains without insertions. Grey circles indicate insertion-containing strains. Triangles, diamonds and squares in grey indicate genetic evolution in codons 67–71. Open arrows indicate time of first diagnosis of insertion rearrangement. Clinical Microbiology and Infection 2004 10, 127-136DOI: (10.1111/j.1198-743x.2003.00864.x) Copyright © 2004 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 2 Temporal evolution of circulating CD4 T-cell count (CD4 as black diamonds in cells/μL) and HIV-1 RNA viral load (VL as open circles in log copies/mL) for 11 patients whose HIV-1 variants contained peptide rearrangements in the RT pol gene. Vertical lines represent the time of the first discovery of insertion rearrangements. Clinical Microbiology and Infection 2004 10, 127-136DOI: (10.1111/j.1198-743x.2003.00864.x) Copyright © 2004 European Society of Clinical Infectious Diseases Terms and Conditions