Update on HIV resistance and resistance testing.

Area of Science:

• Virology
• Immunology
• Pharmacology

Background:

• Highly active antiretroviral therapy (HAART) has significantly reduced HIV-1 morbidity and mortality.
• Antiviral resistance is a major challenge in extensively treated HIV-1 patients, leading to loss of viral control.
• Laboratory tests are crucial for identifying HIV-1 antiviral resistance and guiding treatment selection.

Purpose of the Study:

• To review genotypic and phenotypic assays for assessing HIV-1 antiviral resistance.
• To discuss the advantages, disadvantages, and limitations of current HIV-1 resistance testing methods.
• To explore emerging mutation/drug resistance associations and their implications for HIV-1 resistance assays.

Main Methods:

• Review of existing literature on HIV-1 antiviral resistance assays.
• Analysis of genotypic and phenotypic assay methodologies.
• Discussion of newly developed antivirals and associated resistance assays.

Main Results:

• Both genotypic and phenotypic assays have been developed to assess HIV-1 antiviral resistance.
• The interpretation of genotypic and phenotypic data for predicting drug response is continuously evolving.
• New classes of antivirals, such as fusion inhibitors, are being developed to overcome existing resistance.

Conclusions:

• HIV-1 antiviral resistance necessitates ongoing development of diagnostic assays and therapeutic options.
• Novel resistance assays are being developed to measure resistance to new classes of antivirals.
• Continued research is essential to provide effective treatment options for patients with multi-drug resistant HIV-1.