Abstract
Background : Antiretroviral treatment (ART) has reduced morbidity and mortality due to AIDS. However, treatment options can be impaired by the development of antiretroviral drug resistance. Resistant virus strains can be transmitted to new hosts and, subsequently, can lead to antiretroviral treatment failure. Methods : Th A systematic review of articles on resistance to antiretroviral for HIV-infected individuals, published from January 1, 2014 to June 16, 2014, on SCOPUS and PUBMED databases wascarried out. Search terms were AIDS (Medical Subject Headings [MeSH]), HIV (MeSH), “treatment” (keyword), “resistance” (keyword) and antiretroviral therapy (MeSH). Of the 118 retrieved studies, 24 met the eligibility criteria. Results : The main classes of antiretroviral drugs are Non Nucleoside Reverse Transcriptase Inhibitors (NNRTIs), Nucleoside Reverse Transcriptase Inhibitors (NRTIs), and Protease Inhibitors (PIs). Antiretroviral treatment selects for drug resistance. Resistant strains become prevalent in the population and are transmitted to new patients. Discussion : A higher prevalence of certain mutations are present and characterize resistant strains that are prevalent in the population making it more diffiult to treat these infected individuals. Poor compliance with antiretroviral increases the potential for developing these and other resistant strains. Conclusions : Knowledge of drug resistance generated by mutations is useful for optimizing treatment regimens and to get better responses. Promoting compliance is important to limiting the selection of new resistant strains.
Highlights
The wide use of combination antiretroviral therapy, for example, succeeded in sustained inhibition of viral replication and reduced significantly the morbidity and mortality of human immunodeficiency virus (HIV) related disease. [1,2,3,4,5] treatment options have been impaired by the development of antiretroviral drug resistance
This systematic review aims to present the main classes of drugs for Antiretroviral treatment (ART) and the resistance mechanisms that could lead to antiretroviral treatment failure
Our study demonstrates the utility of molecular and epidemiological analysis of Viral transmission clusters (VTCs) for identifying population-specific risks associated with human immunodeficiency virus type 1 (HIV-1) transmission and developing effective local healthcare strategies
Summary
The wide use of combination antiretroviral therapy (cART), for example, succeeded in sustained inhibition of viral replication and reduced significantly the morbidity and mortality of HIV related disease. [1,2,3,4,5] treatment options have been impaired by the development of antiretroviral drug resistance. Resistant virus strains can develop in a patient but are likely to be acquired from others leading to antiretroviral treatment failure. Antiretroviral therapy resistance is a concern not just for individual patients, and for society due to the high potential transmission of drug-resistant HIV. This compromises the effectiveness of available first-line regimens for a substantial portion of the population and increases the need for costly second-line drugs. This study is based on the following research questions: what are the main mutations conferring resistance to antiretroviral treatments and how do individuals acquire resistant strains? This systematic review aims to present the main classes of drugs for ART and the resistance mechanisms that could lead to antiretroviral treatment failure. Resistant virus strains can be transmitted to new hosts and, subsequently, can lead to antiretroviral treatment failure
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