The Impact of HIV Genetic Polymorphisms and Subtype Differences on the Occurrence of Resistance to Antiretroviral DrugsReportar como inadecuado

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Molecular Biology InternationalVolume 2012 2012, Article ID 256982, 10 pages

Review ArticleJewish General Hospital AIDS Centre, McGill University, 3755 Cote-Ste-Catherine Road, Montreal, QC, Canada H3T 1E2

Received 28 February 2012; Accepted 12 April 2012

Academic Editor: Gilda Tachedjian

Copyright © 2012 Mark A. Wainberg and Bluma G. Brenner. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The vast majority of reports on drug resistance deal with subtype B infections in developed countries, and this is largely due to historical delays in access to antiretroviral therapy ART on a worldwide basis. This notwithstanding the concept that naturally occurring polymorphisms among different non-B subtypes can affect HIV-1 susceptibility to antiretroviral drugs ARVs is supported by both enzymatic and virological data. These findings suggest that such polymorphisms can affect both the magnitude of resistance conferred by some major mutations as well as the propensity to acquire certain resistance mutations, even though such differences are sometimes difficult to demonstrate in phenotypic assays. It is mandatory that tools are optimized to assure accurate measurements of drug susceptibility in non-B subtypes and to recognize that each subtype may have a distinct resistance profile and that differences in resistance pathways may also impact on cross-resistance and the choice of regimens to be used in second-line therapy. Although responsiveness to first-line therapy should not theoretically be affected by considerations of viral subtype and drug resistance, well-designed long-term longitudinal studies involving patients infected by viruses of different subtypes should be carried out.

Autor: Mark A. Wainberg and Bluma G. Brenner



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