Managing patients with sexual transmission of drug-resistant HIV.
The transmission of drug-resistant HIV-1 (primary HIV resistance) is a cause of growing concern. The prevalence of drug-resistant variants in patients with primary HIV-1 infection (PHI) ranges from 10 to 36%. Unlike patients with secondary resistance, patients with primary HIV resistance do not show a rapid conversion to wild-type drug-sensitive virus in the absence of treatment. Moreover, primary HIV-1 resistance is associated with higher rates of treatment failure. Rapid diagnosis is important, since early events in PHI may have a critical role in disease progression. An early diagnosis is also essential to prevent HIV-1 transmission during the high viremic phase of PHI. This review focuses on prevalence, basic principles, diagnostic markers, and approaches for the treatment of PHI due to sexual transmission of drug-resistant HIV-1. The aim of the paper is to help clinicians to deal with patients presenting a PHI due to drug-resistant variants.
Tozzi
Valerio
V
National Institute for Infectious Diseases Lazzaro Spallanzani, Rome, Italy. tozzi@inmi.it
Corpolongo
Angela
A
Bellagamba
Rita
R
Narciso
Pasquale
P
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D024882:Drug Resistance, Viral / Q000187:drug effects; D042241:Early Diagnosis; D005260:Female; D014943:Global Health; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000635:transmission; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006266:Health Education / Q000592:standards; D006291:Health Policy; D006293:Health Promotion / Q000592:standards; D006801:Humans; D008297:Male; D015995:Prevalence; D011322:Primary Prevention / Q000592:standards*
D019380:Anti-HIV Agents