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Personalizing antiretroviral therapy: is it a reality?
Elizabeth J Phillips1,2,3, Simon A Mallal1,2
1Institute for Immunology & Infectious Diseases, Murdoch University, Department of Clinical Immunology & Immunogenetics, 2nd Floor North Block, Royal Perth Hospital, Wellington Street, Perth, Western Australia 6000. e.phillips@iiid.com.au.
Personalized Medicine
|May 23, 2018
Summary
Personalizing antiretroviral therapy considers patient factors. Advances in pharmacogenetics, like HLA-B*5701 screening for abacavir hypersensitivity, enable successful clinical applications.
Area of Science:
- Pharmacogenetics
- HIV/AIDS Research
- Genomics
Background:
- Personalizing antiretroviral therapy (ART) requires considering patient-specific factors (pharmacoecology), including adherence, interactions, and host conditions.
- Recent scientific advances enable exploring host-virus genetic interactions and antiretroviral therapy (ART) pharmacogenetics through candidate and whole-genome approaches.
Purpose of the Study:
- To explore the role of host-virus genetic interactions in HIV pathogenesis and antiretroviral therapy (ART) response.
- To evaluate the clinical applicability of pharmacogenetic studies in HIV management.
Main Methods:
- Review of published HIV pharmacogenetic studies, primarily using a candidate gene approach.
- Analysis of the successful implementation of HLA-B*5701 screening for abacavir hypersensitivity.
Main Results:
- Candidate gene studies have provided insights into HIV pathogenesis, drug disposition, interactions, efficacy, toxicity, and host-virus interactions.
- Few candidate gene studies have translated to widespread clinical application.
Conclusions:
- The successful implementation of HLA-B*5701 screening exemplifies the key steps required for clinical pharmacogenetic test application.
- Further research into host-virus genetics may aid HIV vaccine development and personalized ART strategies.
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