Recent trends in HIV-1 drug resistance.

Recent trends in HIV-1 drug resistance.
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HIV-1 耐药性的最新趋势。

DOI:
10.1016/j.coviro.2013.08.007
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发表时间:
2013-10
影响因子:
5.9
通讯作者:
Siliciano, Robert F.
Siliciano, Robert F.
中科院分区:
医学2区
文献类型:
--
作者:
Siliciano, Janet D.;Siliciano, Robert F.

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曾经被认为是艾滋病毒治疗不可避免的结果,耐药性正在下降。这种下降支持了抗逆转录病毒治疗可以阻止复制和防止耐药性演变的假设。进一步的支持来自于出色的临床结果,强化治疗未能减少残余病毒血症,患者在最佳治疗中缺乏病毒进化,药效学研究解释了现代方案的超高抗病毒活性,以及最近关于潜在治愈的报道。支持持续复制的证据包括在接受治疗的患者中某些并发症的发生率较高,以及在整合酶抑制剂强化后病毒基因组环状形式的增加。最近的研究也提供了一种解释,即一些患者在没有证据表明耐药的情况下未能使用基于蛋白酶抑制剂的治疗方案。
Once considered an inevitable consequence of HIV treatment, drug resistance is declining. This decline supports the hypothesis that antiretroviral therapy can arrest replication and prevent the evolution of resistance. Further support comes from excellent clinical outcomes, the failure of treatment intensification to reduce residual viremia, the lack of viral evolution in patients on optimal therapy, pharmacodynamics studies explaining the extraordinarily high antiviral activity of modern regimens, and recent reports of potential cures. Evidence supporting ongoing replication includes higher rates of certain complications in treated patients and an increase in circular forms of the viral genome after intensification with integrase inhibitors. Recent studies also provide an explanation for the observation that some patients fail protease-inhibitor based regimens without evidence for resistance.
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发表时间: 2012-08-06
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