Drug resistance in non-subtype BHIV-1
Drug resistance in non-subtype BHIV-1
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DOI：
10.1016/s1386-6532(03)00115-x
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发表时间：
2004-03-01
影响因子：
8.8
通讯作者：
Katzenstein, D
中科院分区：
文献类型：
--
作者：
Kantor, R;Katzenstein, D
用抗逆转录病毒疗法治疗HIV-1可以选择与抗逆转录酶抑制剂和蛋白酶抑制剂抗性相关的POT基因中的突变。为了提供持久的临床益处，通过替代药物方案的处方来抵抗耐药性的出现。关于在病毒学衰竭和耐药性选择后有效的顺序治疗的数据很大程度上仅限于HIV-1亚型B，这是在北美和欧洲流传的进化枝。但是，HIV-1亚型B目前仅占全球估计4000万名HIV感染的人的12％。全球HIV-1流行病包括感染9种HIV-1组M亚型（A-K），以及不同的亚基型和许多嵌合或重组形式。通过旅行和迁移，增加了发展中国家的HIV-1治疗方法，并增加了非补充性B感染，这对这些不同的HIV-1病毒对抗逆转录病毒药物的敏感性和反应提出了新的问题。在这里，我们回顾了HIV多样性和有关耐药性的发表文献，将感染了亚型B的个体的已知耐药性突变与在全球范围内的非补充B HIV-1治疗中的越来越多的经验进行了比较。 （c）2003 Elsevier B.V.保留所有权利。
Treatment of HIV-1 with antiretroviral therapy may select mutations in the pot gene associated with resistance to reverse transcriptase inhibitors and protease inhibitors. To provide durable clinical benefit, emergence of drug resistance is countered by prescription of alternative drug regimens. Data on sequential treatments that are effective after virologic failure and the selection of drug resistance is largely confined to HIV-1 subtype B, the clade that has circulated in North America and Europe. However, HIV-1 subtype B currently accounts for only 12% of the estimated 40 million HIV infected individuals worldwide. The global HIV-1 epidemic includes infection with nine identified HIV-1 group M subtypes (A-K), as well as distinct sub-subtypes and numerous chimerical or recombinant forms. Increasing access to treatment of HIV-1 in the developing world and increasing non-subtype B infection through travel and migration pose new questions about the susceptibility and response of these diverse HIV-1 viruses to antiretroviral drugs. Here we review HIV diversity and the published literature on drug resistance, comparing the known resistance mutations in individuals infected with subtype B to the growing experience in the treatment of non-subtype B HIV-1 worldwide. (C) 2003 Elsevier B.V. All rights reserved.