hiv genetic diversity and drug resistance艾滋病毒遗传多样性和耐药性.pdfVIP

Viruses 2010, 2, 503-531; doi:10.3390/v2020503 OPEN ACCESS viruses ISSN 1999-4915 /journal/viruses Review HIV Genetic Diversity and Drug Resistance André F. Santos 1 and Marcelo A. Soares 1,2,* 1 Laboratório de Virologia Humana, Universidade Federal do Rio de Janeiro, CCS, Bloco A, sala A2- 120, Cidade Universitária, Ilha do Fundão, 21949-570, Rio de Janeiro, RJ, Brazil; E-Mail: andre20@ 2 Programa de Genética, Instituto Nacional de Câncer, Rio de Janeiro, Brazil * Author to whom correspondence should be addressed; E-Mail: masoares@biologia.ufrj.br; Tel.: 55-21-2562-6383; Fax: 55-21-2562-6396. Received: 18 November 2009; in revised form: 11 December 2009 / Accepted: 1 February 2010 / Published: 2 February 2010 Abstract: Most of the current knowledge on antiretroviral (ARV) drug development and resistance is based on the study of subtype B of HIV-1, which only accounts for 10% of the worldwide HIV infections. Cumulative evidence has emerged that different HIV types, groups and subtypes harbor distinct biological properties, including the response and susceptibility to ARV. Recent laboratory and clinical data highlighting such disparities are summarized in this review. Variations in drug susceptibility, in the emergence and selection of specific drug resistance mutations, in viral replicative capacity and in the dynamics of resistance acquisition under ARV selective pressure are discussed. Clinical responses to ARV therapy