Novel codon T215C/D/N/S mutations have been described in antiretroviral-naive patients infected with zidovudine-resistant HIV-1-carrying 215F/Y. Viruses with codon 215-revertant genotypes are sensitive to zidovudine and stavudine, but rapidly develop resistance under exposure to these drugs. In pre-treated HIV-infected patients who discontinue zidovudine or stavudine there is no evidence of reversion to these unusual genotypes, because of an overgrowth of preexisting wild-type viruses. Therefore, these novel codon 215 mutations almost always reflect a past primary infection with zidovudine-resistant viruses.