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Viruses. 2014 Oct 20;6(10):3855-72. doi: 10.3390/v6103855.

Impact of human immunodeficiency virus type-1 sequence diversity on antiretroviral therapy outcomes.

Author information

1
Department of Pediatrics, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06520, USA. allison.Langs-barlow@yale.edu.
2
Departments of Pediatrics and Pharmacology, Yale University School of Medicine, Child Health Research Center, 464 Congress Ave, New Haven, CT 06520, USA. elijah.paintsil@yale.edu.

Abstract

Worldwide circulating HIV-1 genomes show extensive variation represented by different subtypes, polymorphisms and drug-resistant strains. Reports on the impact of sequence variation on antiretroviral therapy (ART) outcomes are mixed. In this review, we summarize relevant published data from both resource-rich and resource-limited countries in the last 10 years on the impact of HIV-1 sequence diversity on treatment outcomes. The prevalence of transmission of drug resistant mutations (DRMs) varies considerably, ranging from 0% to 27% worldwide. Factors such as geographic location, access and availability to ART, duration since inception of treatment programs, quality of care, risk-taking behaviors, mode of transmission, and viral subtype all dictate the prevalence in a particular geographical region. Although HIV-1 subtype may not be a good predictor of treatment outcome, review of emerging evidence supports the fact that HIV-1 genome sequence-resulting from natural polymorphisms or drug-associated mutations-matters when it comes to treatment outcomes. Therefore, continued surveillance of drug resistant variants in both treatment-naïve and treatment-experienced populations is needed to reduce the transmission of DRMs and to optimize the efficacy of the current ART armamentarium.

PMID:
25333465
PMCID:
PMC4213566
DOI:
10.3390/v6103855
[Indexed for MEDLINE]
Free PMC Article

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