What if HIV were unable to develop resistance against a new therapeutic agent?

BMC Medicine

Francois Raffi³  Thibault Mesplède²  Mark A Wainberg¹ 

[1] Departments of Medicine and Microbiology, Jewish General Hospital, McGill University, Montreal, QC, Canada;McGill University AIDS Centre, Montreal, QC, Canada;Division of Infectious Diseases, Nantes University Hospital, Nantes, France

关键词: Drug resistance;    Viral fitness;    HIV prevention strategies;    Dolutegravir;    Antiretroviral therapy;    Integrase inhibitors;    Human immunodeficiency virus type 1;   

Others  :  855342
DOI  :  10.1186/1741-7015-11-249

 received in 2013-11-06, accepted in 2013-11-07,  发布年份 2013

【 摘 要 】

Background

The HIV integrase inhibitor, Dolutegravir (DTG), was recently approved by the Food and Drug Administration in the United States and is the only HIV drug that has not selected for resistance mutations in the clinic when used as part of first-line therapy. This has led to speculation that DTG might have a higher genetic barrier for the development of drug resistance than the other compounds that are used in therapy.

Discussion

In this Opinion article, we speculate that this is due to greatly diminished replication capacity on the part of viruses that might become resistant to DTG when the drug is used in initial therapy and that DTG might be able to be used in HIV prevention and eradication strategies. We also note that no compensatory mutation that might restore viral replication fitness to HIV in the aftermath of the appearance of a single drug resistance mutation has yet to be observed.

Summary

DTG is a valuable addition to the anti-HIV armamentarium of drugs and its long-term utility may potentially exceed its obvious use in treatment of HIV disease.

【 授权许可】

   
2013 Wainberg et al.; licensee BioMed Central Ltd.

【 图 表 】

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