The development of Resistance to Antiretroviral Therapy for HIV Infected Individuals:a Systematic Review
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 therapy 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 therapy 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.
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