Antiretroviral Resistance: Mechanisms, Detection and Clinical Implications

Abstract

Widespread use of antiretroviral agents and the epidemic of human immunodeficiency virus (HIV) strains resistant to these drugs have raised a lot of issues including the biology and clinical implications of HIV resistance, reliability of resistant assays and their role in clinical practice. In May 2000, the International AIDS panel endorsed and recommended the use of antiretroviral drug resistance testing in patients. Considerable data on HIV drug resistance testing that strongly suggest that utility of these assays may be of great value have been published and presented at major meetings. Although the genotypic and phenotypic assays are available for antiretroviral drug resistance testing, the testing has certain limitations. The role of these resistance assays is not clearly defined in clinical practice. Prospective studies are needed to define the long-term benefits of these assays. HIV drug resistance testing in the near future may become an important tool and standard of practice for patients infected with HIV. Clinicians caring for HIV-positive patients should be familiar with the antiretroviral drug resistant assays.