Universität zu Köln

Boucher, Charles A., Bobkova, Marina R., Geretti, Anna Maria, Hung, Chien-Ching, Kaiser, Rolf, Marcelin, Anne-Genevieve, Streinu-Cercel, Adrian ORCID: 0000-0001-6382-5067, van Wyk, Jean, Dorr, Pat and Vandamme, Anne-Mieke ORCID: 0000-0002-6594-2766 (2018). State of the Antiretroviral Therapy in Human Immunodeficiency Virus Drug Resistance: Science and Technology Knowledge Gap. Aids Rev., 20 (1). S. 26 - 42. BARCELONA: PERMANYER PUBL. ISSN 1698-6997

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Abstract

Resistance to antiretroviral therapy (ART) threatens the efficacy of human immunodeficiency virus type 1 (HIV-1) treatment. We present a review of knowledge gaps in the science and technologies of acquired HIV-1 drug resistance (HIVDR) in an effort to facilitate research, scientific exchange, and progress in clinical management. The expert authorship of this review convened to identify data gaps that exist in the field of HIVDR and discuss their clinical implications. A subsequent literature review of trials and current practices was carried out to provide supporting evidence. Several gaps were identified across HIVDR science and technology. A summary of the major gaps is presented, with an expert discussion of their implications within the context of the wider field. Crucial to optimizing the use of ART will be -improved understanding of protease inhibitors and, in particular, integrase strand transfer inhibitors (INSTI) in the context of HIVDR. Limited experience with INSTI represents an important knowledge gap in HIV resistance science. Utilizing such knowledge in a clinical setting relies on accurate testing and analysis of resistance-associated mutations. As next-generation sequencing becomes more widely available, a gap in the interpretation of data is the lack of a defined, clinically relevant threshold of minority variants. Further research will provide evidence on where such thresholds lie and how they can be most effectively applied. Expert discussion identified a series of gaps in our knowledge of HIVDR. Addressing such gaps through further research and characterization will facilitate the optimal use of ART therapies and technologies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Boucher, Charles A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bobkova, Marina R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Geretti, Anna Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Hung, Chien-Ching UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaiser, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Marcelin, Anne-Genevieve UNSPECIFIED UNSPECIFIED UNSPECIFIED Streinu-Cercel, Adrian UNSPECIFIED orcid.org/0000-0001-6382-5067 UNSPECIFIED van Wyk, Jean UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorr, Pat UNSPECIFIED UNSPECIFIED UNSPECIFIED Vandamme, Anne-Mieke UNSPECIFIED orcid.org/0000-0002-6594-2766 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-202993
DOI:	10.24875/AIDSRev.M18000018
Journal or Publication Title:	Aids Rev.
Volume:	20
Number:	1
Page Range:	S. 26 - 42
Date:	2018
Publisher:	PERMANYER PUBL
Place of Publication:	BARCELONA
ISSN:	1698-6997
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language REVERSE-TRANSCRIPTASE INHIBITORS; TREATMENT-NAIVE PATIENTS; NON-INFERIORITY TRIAL; HIV-INFECTED PATIENTS; LOW-LEVEL VIREMIA; STRAND TRANSFER INHIBITORS; RITONAVIR PLUS LAMIVUDINE; TWICE-DAILY LOPINAVIR/RITONAVIR; ONCE-DAILY ATAZANAVIR/RITONAVIR; VIRAL REPLICATION CAPACITY Multiple languages Immunology; Infectious Diseases Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20299