Minority Variants of Drug-Resistant HIV
Minority Variants of Drug-Resistant HIV
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DOI：
10.1086/655397
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发表时间：
2010-09-01
影响因子：
6.4
通讯作者：
Richman, Douglas D.
中科院分区：
文献类型：
--
作者：
Gianella, Sara;Richman, Douglas D.
每个感染人类免疫缺陷病毒（HIV）的患者中都存在轻微的耐药变异。由于这些少数变异体通常以非常低的水平存在，因此无法使用常规基因型和表型检测来检测和定量。最近，已经开发了几种检测方法来表征这些低丰度的耐药变异体，这些变异体存在于每个HIV感染个体中的庞大的遗传复杂的群体中。最重要的问题是这些检测产生的结果可以预测临床或治疗结果，并可能指导临床实践中的患者管理。应确定检测这些低丰度病毒变异体的临界值，以预测治疗失败的风险增加。这些阈值对于每种突变和治疗方案可以是特异性的。在这篇综述中，我们总结了目前可用的检测方法的属性和局限性，并回顾了获得性和传播性耐药少数变异的现有信息。
Minor drug-resistant variants exist in every patient infected with human immunodeficiency virus (HIV). Because these minority variants are usually present at very low levels, they cannot be detected and quantified using conventional genotypic and phenotypic tests. Recently, several assays have been developed to characterize these low-abundance drug-resistant variants in the large, genetically complex population that is present in every HIV-infected individual. The most important issue is what results generated by these assays can predict clinical or treatment outcomes and might guide the management of patients in clinical practice. Cutoff values for the detection of these low-abundance viral variants that predict an increased risk of treatment failure should be determined. These thresholds may be specific for each mutation and treatment regimen. In this review, we summarize the attributes and limitations of the currently available detection assays and review the existing information about both acquired and transmitted drug-resistant minority variants.