Human immunodeficiency virus type 1 infection is associated with high rates of virus
replication in an untreated individual. Because the viral reverse transcriptase (RT)
lacks proof-reading capability, the high replication rate allows the evolution of
considerable genetic diversity even within the population of HIV-1 in a single infected
individual [
[1]
]. If a limited drug-selective pressure is imposed on this heterogeneous population,
pre-existing strains of HIV-1 with decreased susceptibility to the drug are favored
and predominate unless replication of virus is curtailed by potent antiretroviral
activity [
[2]
]. Every approved antiretroviral agent used as monotherapy will eventually select for
resistant virus. In contrast, the use of multiple agents in combination brings about
potent suppression of virus replication, thereby severely diminishing the opportunity
for resistance to evolve, and allowing long-term control of viremia. Despite highly
active antiretroviral therapy, however, breakthrough viremia and drug resistance can
still occur. This article focuses on the use of antiretroviral drug resistance assays
in the clinical management of HIV-1 infection.To read this article in full you will need to make a payment
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Article info
Footnotes
☆This work is supported by Grant No. AI-01696 from the National Institutes of Health.
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© 2002 Elsevier Science (USA). Published by Elsevier Inc. All rights reserved.
