[The pharmacogenetics of response to antiretroviral therapy]

The plasma concentrations of most antiretroviral drugs show wide interindividual variability, which may lead to differences in response rate and toxicity. Among the factors determining this variable exposure to antiviral drugs are differences in metabolism, interactions due to the use of concomitant medication, problems in treatment adherence, underlying diseases, and host genetic factors. Pharmacogenetics analyzes the genetic bases of interindividual variation in the bioavailability and response to drugs. The aim is to establish the foundations for individualized therapy. Among the genetic factors that are in some way involved in antiretroviral treatment response are those that directly or indirectly affect antiviral plasma concentrations, as is the case of drug transport proteins and metabolizing enzymes. Some host factors also influence antiviral response, such as interleukins and major histocompatibility complex. The present article analyzes the most important genetic markers associated with antiretroviral treatment response.