Fast Five Quiz: Treatment-Resistant HIV

Michael Stuart Bronze, MD

Disclosures

May 10, 2021

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 treatment-naive individuals. This is known as "transmitted drug resistance" and is the result of infection with an HIV strain containing one or more resistance-associated mutations. Most often, this transmission occurs at the time of initial infection, but it can also happen during a later exposure, resulting in an HIV superinfection.

Poor 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 optimize 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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