Fast Five Quiz: Treatment-Resistant HIV

Michael Stuart Bronze, MD; Enrico Brunetti, MD


August 14, 2023

Figure 1. A scanning electron microscopic image of the structure of HIV.

Specific mutations associated with HIV drug resistance have been identified. Such mutations have been shown to contribute to a reduced virologic response to an HIV drug.

HIV drug resistance has been found in individuals who are treatment-naive. 'Transmitted drug resistance' is the result of an HIV strain containing one or more resistance-associated mutations being transmitted at the time of initial infection, although transmission can also happen during a later exposure, resulting in an HIV superinfection.

Poor treatment adherence and/or treatment interruption can result in treatment failure and acquired HIV drug resistance that may compromise forthcoming treatment options. It is important to discuss strategies to optimise adherence, care engagement and ART access with all patients.

There is largely no cross-resistance between ART drug classes, meaning that viruses that are resistant to drugs in one antiretroviral (ARV) class are fully susceptible to ARVs from unused classes. However, substantial cross-resistance within a drug class is common. As such, knowledge of ARV cross-resistance profiles is vital when using more than one drug from the same ARV class either in combination or in sequence.

Learn more about the treatment of HIV.


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