Research on Chronic Diseases

Drug Resistance Of HIV

microevolution causes virions to become tolerant to antiretroviral treatments (ART). ART can be used to successfully manage HIV infection, but a number of factors can contribute to the virus mutating and becoming resistant. Drug resistance occurs as bacterial or viral populations evolve to no longer respond to medications that previously worked. In the case of HIV, there have been recognized cases of treatment resistant strains since 1989, with drug resistance being a major contributor to treatment failure.[1] While global incidence varies greatly from region to region, there has been a general increase in overall HIV drug resistance. The two main types of resistance, primary and induced, differ mostly in causation, with the biggest cause of resistance being a lack of adherence to the specific details of treatment. These newly created resistant strains of HIV pose a public health issue as they infect a growing number of people because they are harder to treat, and can be spread to other individuals.[2] For this reason, the reaction to the growing number of cases of resistant HIV strains has mostly been to try to increase access to treatment and implement other measures to make sure people stay in care, as well as to look into the development of a HIV vaccine or cure HIV is considered resistant when it no longer respond to known treatments.[5] Because currently there is no known cure for HIV, the goal of treatment is to reduce an infected individual's viral load to the point where it is no longer detectable in order to alleviate their symptoms and reduce their risk of infecting others.[6] HIV drug resistance poses an issue because it reduces the possible HIV medications a person can take due to cross resistance. In cross resistance, an entire class of medication is considered ineffective in lowering a patient's HIV viral load because all the drugs in a given class share the same mechanism of action.[7] Therefore, development of resistance to one medication in a class precludes the use of all other medications in the same class. A blood test can be done to determine which drugs may be effective prior to initiation of treatment or during treatment to ensure resistance has not developed.[7]    

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