Update of the drug resistance mutations in HIV-1: 2007.
Update of the drug resistance mutations in HIV-1: 2007.
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HIV-1 耐药突变的更新：2007 年。
DOI：
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发表时间：
2007
期刊：
影响因子：
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通讯作者：
D. Richman
中科院分区：
文献类型：
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作者：
V. Johnson;F. Brun;B. Clotet;H. Günthard;D. Kuritzkes;D. Pillay;J. Schapiro;D. Richman
药物失败的对象；(4)基线基因型与接触药物患者的病毒学反应之间的相关性研究。该小组审查了已经发表或在科学会议上提交的数据。已获得美国食品和药物管理局(FDA)批准的药物以及扩大准入计划(EAP)中提供的药物也包括在内。它们按药物类别的字母顺序列出。用户说明可根据需要提供其他信息。尽管耐药突变小组致力于维护这些突变的完整和最新列表，但不能假设这里提供的列表是详尽的。鼓励读者查阅文献和该领域的专家，以澄清或了解有关特定突变及其临床影响的更多信息。在做出关于抗逆转录病毒治疗的临床决策的背景下，对艾滋病毒基因检测结果的评估包括：(1)评估突变模式是否与患者的抗逆转录病毒病史一致；(2)认识到在没有药物(选择压力)的情况下，耐药株可能存在于低于检测极限的水平(分析储存的样本，在选择压力下收集，在这种情况下可能是有用的)；以及(3)认识到第一种方案的病毒学失败通常涉及只对方案中的一种或两种药物产生抗药性的HIV-1分离株(在这种情况下，最常见的是对拉米夫定或非核苷逆转录酶抑制剂[NNRTIs]产生抗药性)。2-7治疗失败后没有检测到病毒耐药性的原因可能是存在耐药的少数病毒群体、不坚持用药、实验室错误、药物与药物的相互作用导致药物水平低于治疗水平，以及可能的隔室问题，这表明药物可能在特定的细胞或组织储存库中没有达到最佳水平。
whom the drug is failing; (4) correlation studies between genotype at baseline and virologic response in patients exposed to the drug. The group reviews data that have been published or have been presented at a scientific confer ence. Drugs that have been approved by the US Food and Drug Administration (FDA) as well as drugs available in expanded access programs (EAPs) are included. They are listed in alphabetic order by drug class. User notes provide additional information as necessary. Although the Drug Resistance Mutations Group works to maintain a complete and current list of these mutations, it cannot be assumed that the list presented here is exhaustive. Readers are encouraged to consult the literature and experts in the field for clarification or more information about specific mutations and their clinical impact. In the context of making clinical decisions regarding antiretroviral therapy, evaluating the results of HIV genotypic testing includes: (1) assessing whether the pattern or absence of a pattern in the mutations is consistent with the patient’s antiretroviral history; (2) recognizing that in the absence of drug (selection pressure), resistant strains may be present at levels below the limit of detection of the test (analyzing stored samples, collected under selection pressure, could be useful in this setting); and (3) recognizing that virologic failure of the first regimen typically involves HIV-1 isolates with resistance to only 1 or 2 of the drugs in the regimen (in this setting, resistance most commonly develops to lamivudine or the nonnucleoside reverse transcriptase inhibitors [NNRTIs]). 2-7 The absence of detectable viral resistance following treatment failure may result from the presence of drug-resistant minority viral populations, nonadherence to medications, laboratory error, drug-drug interactions leading to subtherapeutic drug levels, and possibly compartmental issues, indicating that drugs may not reach optimal levels in specific cellular or tissue reservoirs.
影响因子：
56.9
作者：
LARDER, BA;DARBY, G;RICHMAN, DD
通讯作者：
RICHMAN, DD