HIV-1 Antiretroviral ResistanceScientific Principles and Clinical Applications

被引：235
作者：
Michele W. Tang
Robert W. Shafer
机构：
[1] Stanford University,Division of Infectious Diseases
来源：
Drugs | 2012年 / 72卷 / 9期
关键词：
Tenofovir; Efavirenz; Virological Failure; Raltegravir; Maraviroc;
D O I：
10.2165/11633630-000000000-00000
中图分类号：
学科分类号：
摘要：
The efficacy of an antiretroviral (ARV) treatment regimen depends on the activity of the regimen’s individual ARV drugs and the number of HIV-1 mutations required for the development of resistance to each ARV — the genetic barrier to resistance. ARV resistance impairs the response to therapy in patients with transmitted resistance, unsuccessful initial ARV therapy and multiple virological failures. Genotypic resistance testing is used to identify transmitted drug resistance, provide insight into the reasons for virological failure in treated patients, and help guide second-line and salvage therapies. In patients with transmitted drug resistance, the virological response to a regimen selected on the basis of standard genotypic testing approaches the responses observed in patients with wild-type viruses. However, because such patients are at a higher risk of harbouring minority drug-resistant variants, initial ARV therapy in this population should contain a boosted protease inhibitor (PI) — the drug class with the highest genetic barrier to resistance.
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页码：e1 / e25
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