Fig. 2

Plasma drug concentrations and emergence of FTC resistance. a Plasma concentrations of tenofovir (TFV, blue), emtricitabine (FTC, red), and dolutegravir (DTG, green) are shown for one pre-treatment (11/25/14) and four post-treatment samples (3/12/15, 9/25/15, 3/16/16, 1/17/17; viral loads corresponding to these time points are depicted in Fig. 1b). Limits of detection (LOD) for FTC and TFV/DTG are shown as red and blue dashed lines, respectively. The in vitro 90% HIV-1 inhibitory concentrations (IC₉₀) for FTC and DTG are shown in red and green dotted lines, respectively. The in vitro 50% HIV-1 inhibitory concentrations (IC₅₀) of TFV (7.8 μg/ml) is off-scale and thus not shown. b Mutations in reverse transcriptase and integrase regions associated with TFV, FTC, and DTG drug resistance in HIV-1 infection. A schematic representation of pol gene proteins is shown with common amino acid substitutions known to confer drug resistance indicated. Pol sequences generated from Cotton’s plasma using SGA approaches are listed by time points. Residues that are mutated compared to the pre-treatment consensus sequence are highlighted in color (identical residues are shown in grey). Pol sequences were also analyzed for less common substitutions associated with DTG resistance [54], but were free of such mutations