The crosstalk between antiretrovirals pharmacology and HIV drug resistance.

The crosstalk between antiretrovirals pharmacology and HIV drug resistance. Expert Rev Clin Pharmacol. 2020 Jun 14;: Authors: Giacomelli A, Pezzati L, Rusconi S Abstract INTRODUCTION: The clinical development of antiretroviral drugs has been followed by a rapid and concomitant development of HIV drug resistance. The development and spread of HIV drug resistance is due on the one hand to the within-host intrinsic HIV evolutionary rate and on the other to the wide use of low genetic barrier antiretrovirals. AREAS COVERED: We searched PubMed and Embase on January 31, 2020, for studies reporting antiretroviral resistance and pharmacology. In this review we assessed the molecular target and mechanism of drug resistance development of the different antiretroviral classes focusing on the currently approved antiretroviral drugs. Then we assessed the main pharmacokinetic/pharmacodynamic of the antiretrovirals. Finally, we retraced the history of antiretroviral treatment and its interconnection with antiretroviral worldwide resistance development both in high, low and middle-income countries in the perspective of 90-90-90 World Health Organization target. EXPERT OPINION: Drug resistance development is an invariably evolutionary driven phenomenon, which challenge the 90-90-90 target. In high income countries the antiretroviral drug resistance seems to be stable since the last decade. On the contrary, multi intervention strategie...
Source: Expert Review of Clinical Pharmacology - Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research