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Update on HIV resistance and resistance testing
Author(s) -
Sebastian Joseph,
Faruki Hawazin
Publication year - 2004
Publication title -
medicinal research reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.868
H-Index - 130
eISSN - 1098-1128
pISSN - 0198-6325
DOI - 10.1002/med.10057
Subject(s) - drug resistance , ccr5 receptor antagonist , reverse transcriptase , virology , viral replication , human immunodeficiency virus (hiv) , resistance mutation , viral life cycle , biology , protease inhibitor (pharmacology) , virus , medicine , viral load , antiretroviral therapy , immunology , genetics , polymerase chain reaction , gene , chemokine , immune system , chemokine receptor
Abstract The introduction of highly active antiretroviral therapy, including a combination of antivirals directed at various steps in the viral life cycle, has led to significant decreases in morbidity and mortality associated with human immunodeficiency virus (HIV‐1) infections. Despite the availability of numerous antivirals, many extensively treated patients gradually loose the ability to control viral replication because of development of antiviral resistance. Laboratory tests have been developed and validated to assist in recognizing such resistance and to help predict which antivirals may be more likely to control viral replication in a given patient. Both genotypic and phenotypic assays have been developed to assess HIV‐1 antiviral resistance. The assay methodologies, including the advantages and disadvantages of each method, as well as the limitations of each method are reviewed. The ability to predict likely drug response from a genotype or a phenotype is continually evolving, and the more recently discovered mutation/drug resistance associations are discussed in terms of their implications for HIV resistance assays. To provide additional options for those who have developed resistance to all currently available drugs, new antivirals, such as the fusion inhibitors, are being developed. These new classes of antivirals block the HIV viral life cycle at sites other than reverse transcriptase and protease. Unique and novel resistance assays are being developed to measure HIV resistance to these new drugs. © 2003 Wiley Periodicals, Inc. Med Res Rev, 24, No. 1, 115–125, 2004