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Previous Volume 350:1023-1035 March 4, 2004 Number 10 Next

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The use of combinations of antiretroviral drugs has proven remarkably effective in controlling the progression of human immunodeficiency virus (HIV) disease and prolonging survival,¹ but these benefits can be compromised by the development of drug resistance.^2,3 Resistance is the consequence of mutations that emerge in the viral proteins targeted by antiretroviral agents. In the United States, as many as 50 percent of patients receiving antiretroviral therapy are infected with viruses that express resistance to at least one of the available antiretroviral drugs.⁴ Consequently, the transmission of drug-resistant strains is also a growing concern.^5,6,7 Because drug-resistant HIV often exhibits resistance to . . . [Full Text of this Article]

Principles of Drug Therapy for HIV

Development of Resistance

Induced Resistance

Primary Resistance

Mechanisms of Resistance

Resistance to Nucleoside and Nucleotide Analogues

            Impairment of Analogue Incorporation

            Removal of the Analogue from the Terminated DNA Chain

Resistance to Nonnucleoside Reverse-Transcriptase Inhibitors

Resistance to Protease Inhibitors

Resistance to Fusion Inhibitors

Cross-Resistance

Evolution of Resistance

Effect of Resistance on Viral Replicative and Pathogenic Capacity

Minority and Archived Populations of Virus

Testing for Drug Resistance

Perspectives

Source Information

From the Unité de Recherche Antivirale, Institut National de la Santé et de la Recherche Médicale, Unité 552, Hôpital Bichat–Claude Bernard, Paris.

Address reprint requests to Dr. Clavel at INSERM, U552, IMEA, Hôpital Bichat–Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France, or at clavel@bichat.inserm.fr.

Related Letters:

HIV Drug Resistance
Calmy A., Pascual F., Ford N.
Extract | Full Text | PDF  
N Engl J Med 2004; 350:2720-2721, Jun 24, 2004. Correspondence

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