Antiretroviral Drug Resistance: Mechanisms, Pathogenesis, Clinical Significance

Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 394)


Since HIV drug resistance was first recognized, many studies have documented the emergence of isolates with reduced susceptibility under the selective pressure of drug therapy, both in vitro and in vivo. These resistant isolates have been identified for nucleosides, non-nucleoside reverse transcriptase inhibitors (NNRTI) and protease inhibitors. Resistant isolates have been characterized with regard to cross resistance to other drugs, enzymatic activity of the target protein, mutations in the target gene and protein, and the relationship of these mutations to the x-ray crystallographic structure of the enzyme. Many of these aspects of HIV drug resistance were reviewed in some detail in the preceding symposium proceedings.’ I shall briefly summarize the status of the in vitro data with reverse transcriptase inhibitors before concentrating upon more recent developments in the field relating to resistance to protease inhibitors, the interrelationships of pathogenesis and drug resistance, and the clinical significance of drug resistance.


Human Immunodeficiency Virus Human Immunodeficiency Virus Type Resistance Mutation Antimicrob Agent Drug Resistance Mutation 
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