First Report on a T69-ins Insertion in CRF06_cpx HIV Type 1

Insertion mutations at codon 69 (T69-ins insertion) of the human immunodeficiency virus type 1 (HIV-1) reverse transcriptase confer full resistance to all approved nucleoside reverse transcriptase inhibitors. To date, nearly all reports on T69-ins insertions have described subtypes B and rarely subtypes A, C, and F of HIV-1. Here, we provide the first report of a T69-ins insertion in circulating recombinant form (CRF) 06_cpx in a patient who had been treated with a zidovudine/didanosine combination for 18 months and then shifted to lamivudine, stavudine, and nelfinavir for 76 months. Thereafter, the patient was additively administered Korean red ginseng. This is the first report on the appearance of the T69-ins insertion mutation in CRF HIV-1.