Abstract
Most of the current knowledge on antiretroviral (ARV) drug development and resistance is based on the study of subtype B of HIV-1, which only accounts for 10% of the worldwide HIV infections. Cumulative evidence has emerged that different HIV types, groups and subtypes harbor distinct biological properties, including the response and susceptibility to ARV. Recent laboratory and clinical data highlighting such disparities are summarized in this review. Variations in drug susceptibility, in the emergence and selection of specific drug resistance mutations, in viral replicative capacity and in the dynamics of resistance acquisition under ARV selective pressure are discussed. Clinical responses to ARV therapy and associated confounding factors are also analyzed in the context of infections by distinct HIV genetic variants.
Highlights
Genesis of HIV Types and GroupsThe human immunodeficiency virus (HIV) has been characterized in 1983 as the causative agent of the acquired immunodeficiency syndrome (AIDS) [1,2], its presence in the human population has been dated back to between the 1900s and early 1920s [3,4]
A few studies have been conducted on drug susceptibility of different human immunodeficiency virus (HIV)-1 subtypes from treatment-naïve subjects. They have shown that drugs belonging to the protease inhibitor (PI), nucleoside reverse transcriptase inhibitors (NRTI) and nucleoside reverse transcriptase inhibitor (NNRTI) classes are highly efficient in inhibiting HIV-1 non-B subtypes [78,79,80,81,82,83,84]
As the technology for the achievement of HIV eradication and of the formulation of an effective sterilizing HIV vaccine are still beyond our knowledge, antiretroviral therapy is yet to be further disseminated in the future, in developing countries
Summary
The human immunodeficiency virus (HIV) has been characterized in 1983 as the causative agent of the acquired immunodeficiency syndrome (AIDS) [1,2], its presence in the human population has been dated back to between the 1900s and early 1920s [3,4]. HIV belongs to the Retroviridae family, and to the Lentivirus genus This genus comprises both types of HIV (HIV-1 and HIV-2), in addition to a large number of simian immunodeficiency viruses (SIV) that infect naturally different non-human primate species in the African continent [7,8]. HIV-1 group O (Outlier) is the most divergent group (Figure 1), and it has recently been suggested it could have originated from SIV that infected wild gorillas (SIVgor) [13]. The HIV-1O epidemic pattern is restricted to the West and Central Africa, and around 15,000 people are estimated to be infected with this variant in Cameroon [15,16]. A new HIV-1 group (P) was described in a Cameroonian woman [21] The origin of this group was correlated with SIVgor, without evidence of recombination with other.
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