Chan Philip A, Kantor Rami
HIV Ther. 2009 Sep 1;3(5):447-465. doi: 10.2217/hiv.09.30.
HIV-1 nonsubtype B variants account for the majority of HIV infections worldwide. Drug resistance in individuals who have never undergone antiretroviral therapy can lead to early failure and limited treatment options and, therefore, is an important concern. Evaluation of reported transmitted drug resistance (TDR) is challenging owing to varying definitions and study designs, and is further complicated by HIV-1 subtype diversity. In this article, we discuss the importance of various mutation lists for TDR definition, summarize TDR in nonsubtype B HIV-1 and highlight TDR reporting and interpreting challenges in the context of HIV-1 diversity. When examined carefully, TDR in HIV-1 non-B protease and reverse transcriptase is still relatively low in most regions. Whether it will increase with time and therapy access, as observed in subtype-B-predominant regions, remains to be determined.
HIV-1非B亚型变异株在全球范围内的HIV感染中占大多数。从未接受过抗逆转录病毒治疗的个体出现耐药性会导致早期治疗失败且治疗选择有限，因此这是一个重要问题。由于定义和研究设计各异，对报告的传播性耐药（TDR）进行评估具有挑战性，而HIV-1亚型的多样性又进一步使其复杂化。在本文中，我们讨论了各种突变列表对TDR定义的重要性，总结了非B亚型HIV-1中的TDR，并强调了在HIV-1多样性背景下TDR报告和解读方面的挑战。仔细研究后发现，在大多数地区，HIV-1非B型蛋白酶和逆转录酶中的TDR仍然相对较低。它是否会像在以B亚型为主的地区那样随着时间推移和治疗机会的增加而上升，仍有待确定。
