Resistance to protease inhibitors.
Resistance to HIV-1 protease inhibitors (PIs) limits the benefits of highly active antiretroviral therapy (HAART) and complicates the selection of appropriate salvage therapy for a growing number of patients. Initial patterns of drug resistance depend on the PI used in treatment, viral subtype and level of drug exposure. Impaired replication capacity of PI-resistant viruses contributes to the maintenance of immunological stability despite ongoing virus replication. However, the accumulation of additional mutations leads eventually to higher levels of drug resistance and immunological decline. Resistance may be overcome by pharmacological enhancement of plasma PI levels, but newer drugs that are active against PI-resistant viruses are needed.
Kuritzkes
Daniel R
DR
Partners AIDS Research Center, Cambridge, MA 02139, USA. dkuritzkes@partners.org
D023241:Antiretroviral Therapy, Highly Active; D024882:Drug Resistance, Viral / Q000235:genetics*; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology; D016333:HIV Protease / Q000235:genetics; D017320:HIV Protease Inhibitors / Q000494:pharmacology*; D015497:HIV-1 / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D006801:Humans; D008826:Microbial Sensitivity Tests; D009154:Mutation
D017320:HIV Protease Inhibitors; D016333:HIV Protease