n Southern African Journal of HIV Medicine - Resistance to antiretroviral agents : drug resistance

Volume 3, Issue 2
  • ISSN : 1608-9693
  • E-ISSN: 2078-6751



HIV resistance to antiretroviral agents accounts for a significant proportion of treatment failures. Resistance is the consequence of genetic changes (mutations) that emerge when there is ongoing HIV replication in the face of inadequate concentrations of antiretroviral agents. Factors that contribute to subtherapeutic drug levels include poor penetration of compounds into certain body sites [e.g. brain, testis, retina), inadequate patient adherence, and variable pharmacokinetics (e.g. due to drug-drug interactions, poor absorption, cellular efflux pumps).

A particular clinical problem is that an HIV mutant resistant to one drug frequently exhibits significant cross-resistance to other drugs, including agents that have not been used to treat the patient. Cross-resistance can significantly limit an individual's future treatment options.

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