Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jun 17:2013:481314.
doi: 10.1155/2013/481314. Print 2013.

HIV-1 Genetic Variability and Clinical Implications

Maria Mercedes Santoro  1 , Carlo Federico Perno
Affiliations

HIV-1 Genetic Variability and Clinical Implications

Maria Mercedes Santoro et al. ISRN Microbiol. .

Abstract

Despite advances in antiretroviral therapy that have revolutionized HIV disease management, effective control of the HIV infection pandemic remains elusive. Beyond the classic non-B endemic areas, HIV-1 non-B subtype infections are sharply increasing in previous subtype B homogeneous areas such as Europe and North America. As already known, several studies have shown that, among non-B subtypes, subtypes C and D were found to be more aggressive in terms of disease progression. Luckily, the response to antiretrovirals against HIV-1 seems to be similar among different subtypes, but these results are mainly based on small or poorly designed studies. On the other hand, differences in rates of acquisition of resistance among non-B subtypes are already being observed. This different propensity, beyond the type of treatment regimens used, as well as access to viral load testing in non-B endemic areas seems to be due to HIV-1 clade specific peculiarities. Indeed, some non-B subtypes are proved to be more prone to develop resistance compared to B subtype. This phenomenon can be related to the presence of subtype-specific polymorphisms, different codon usage, and/or subtype-specific RNA templates. This review aims to provide a complete picture of HIV-1 genetic diversity and its implications for HIV-1 disease spread, effectiveness of therapies, and drug resistance development.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Steps of HIV-1 life cycle targeted by antiretroviral drugs and relative impact of HIV-1 subtype on resistance development. Blue boxes represent the crucial steps of HIV-1 life cycle targeted by antiretrovirals. Red boxes report the drug classes available in clinics and the HIV-1 genetic characteristics related to subtype potentially involved in resistance development. EIs: Entry inhibitors; IN: integrase; INI: integrase inhibitors; NRTIs: nucleotide reverse transcriptase inhibitor; NNRTI: non-NRTIs; RT: reverse transcriptase; PR: protease.
Figure 2
Figure 2
Different subtype associated RNA templates and development of NRTIs resistance in B and C subtypes. The figure represents the differences between subtype B (a) and subtype C (b), observed at nucleotide level in reverse transcriptase codons 64-65-66. AZT: zidovudine, d4T: stavudine, ddI: didanosine, ABC: abacavir, and TDF: tenofovir (modified by [15]).
See this image and copyright information in PMC

References

    1. Barre Sinoussi F, Chermann JC, Rey F. Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS) Science. 1983;220(4599):868–871. - PubMed
    1. Coffin J, Haase A, Levy JA, et al. Human immunodeficiency viruses. Science. 1986;232(4751):p. 697. - PubMed
    1. Gallo RC, Sarin PS, Gelmann EP. Isolation of human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS) Science. 1983;220(4599):865–867. - PubMed
    1. Levy JA, Hoffman AD, Kramer SM. Isolation of lymphocytopathic retroviruses from San Francisco patients with AIDS. Science. 1984;225(4664):840–842. - PubMed
    1. Clavel F, Guétard D, Brun-Vézinet F, et al. Isolation of a new human retrovirus from West African patients with AIDS. Science. 1986;233(4761):343–346. - PubMed

LinkOut - more resources