Nonnucleoside reverse transcriptase (RT) inhibitors (NNRTIs) are important components of multidrug therapy for HIV-1. Understanding the effect of NNRTI-resistant mutants on virus replication and reverse transcriptase (RT) function is valuable for the development of extended-spectrum NNRTIs. We measured the fitness of six NNRTI-resistant mutants, the K103N, V106A, Y181C, G190A, G190S, and P236L viruses, using a flow cytometry-based cell culture assay. K103N and Y181C viruses had fitness similar to that of the wild type while V106A, G190A, G190S, and P236L viruses had reduced fitness. We also determined the biochemical correlates of fitness by measuring the RNase H and polymerization activities of recombinant mutant RTs and virion-associated RTs. The RNase H activities of recombinant and virion-associated RTs correlated with the relative fitness for each mutant. K103N and Y181C mutants had normal RNase H activity; V106A, G190A, and G190S mutants had moderate reductions in activity; and the P236L mutant had substantially reduced activity. With the exception of the P236L mutant, reduced fitness correlates with low virion-associated polymerization efficiency and reduced RT content. Reduced polymerase function in virions derived from low RT content rather than an intrinsic polymerization defect in each RT protein. In conclusion, severe defects in RNase H activity alone, exemplified by the P236L mutant, appear sufficient to cause a substantial reduction in fitness. For the other NNRTI mutants, reductions in RT content decreased both polymerization and RNase H activity in virions. RNase H reduction was compounded by intrinsic RNase H defects in the mutant RTs.HIV-1 reverse transcriptase (RT) is a multifunctional enzyme that converts the single-stranded RNA viral genome into double-stranded DNA. It has RNA-and DNA-dependent DNA polymerase activities, which copy RNA or DNA templates, respectively, into double-stranded DNA, as well as RNase H activity that cleaves genomic RNA still hybridized to DNA (40). Although both activities are essential for HIV-1 replication, some studies have shown that polymerization and RNase H activities are not rigorously coupled (11,12,27,36). RT is a heterodimer comprised of two subunits, a 66-kDa (p66) subunit and a 51-kDa (p51) subunit (20). The p66 subunit has both the polymerase and RNase H domains, which make contact simultaneously with the RNA genome (12). The p51 subunit is an N-terminal cleavage product of p66 which lacks the RNase H domain and serves as a structural scaffold for the p66 subunit (2).Because of its essential role in the virus life cycle, RT is an important antiretroviral target for the treatment of HIV-1. Nonnucleoside RT inhibitors (NNRTIs) are one of three classes of antiretroviral RT inhibitors that are commonly used in treatment. They are a group of structurally diverse small hydrophobic compounds, which can specifically bind and inhibit RT (reviewed in reference 34). One limitation of NNRTIs is that they face a low genetic barrier to resistance. Previous studies o...