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Titolo:
Nonnucleoside reverse transcriptase inhibitor resistance
Autore:
Deeks, SG;
Indirizzi:
San Francisco Gen Hosp, San Francisco, CA 94110 USA San Francisco Gen Hosp San Francisco CA USA 94110 Francisco, CA 94110 USA Univ Calif San Francisco, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA
Titolo Testata:
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
, volume: 26, anno: 2001, supplemento:, 1
pagine: S25 - S33
SICI:
1525-4135(20010301)26:<S25:NRTIR>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN-IMMUNODEFICIENCY-VIRUS; HIV-1 INFECTION; ANTIRETROVIRAL THERAPY; DOUBLE-BLIND; TYPE-1; NEVIRAPINE; ZIDOVUDINE; DIDANOSINE; MUTATIONS; DELAVIRDINE;
Keywords:
NNRTI resistance; point mutations; fitness; cross-resistance; viral transmission;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Deeks, SG San Francisco Gen Hosp, 995 Portrero Ave,Bldg 80,Ward 84, San Francisco, CA 94110 USA San Francisco Gen Hosp 995 Portrero Ave,Bldg 80,Ward 84 San Francisco CA USA 94110
Citazione:
S.G. Deeks, "Nonnucleoside reverse transcriptase inhibitor resistance", J ACQ IMM D, 26, 2001, pp. S25-S33

Abstract

Although understanding of nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance is less clearly established than that of other classes of antiretroviral drugs, certain facts have been established. The treatment-associated genetic mutation profiles of the available NNRTIs have been mapped, and resistance has been found to develop rapidly after initiation of NNRTI therapy. Despite the chemical diversity of the NNRTIs, cross-resistance among agents of this class is nearly universal. Although the viral replicative capacity ("fitness") of NNRTI-induced viral variants has not been extensively studied, available data suggest that NNRTI-selected mutations confer little damage to viral fitness, and thus a single point mutation produces astrain that is both resistant and fit. Furthermore, with continued therapy, viral evolution persists, creating species with greater numbers of mutations and higher level phenotypic resistance. Taken together, these facts suggest that continued use of NNRTIs after emergence of resistance will produce variants of complex mutational patterns that limit future treatment options, and, therefore, strong consideration should be given to discontinuing NNRTIs after virologic failure is confirmed. This article describes the scientific literature establishing the efficacy and limitations of NNRTI therapy and attempts to define a role for this class of drug in the long-term treatment of HIV-1 disease.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 15:47:02