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Review
. 2024 Apr 20;12(4):915.
doi: 10.3390/biomedicines12040915.

The Phenomenon of Antiretroviral Drug Resistance in the Context of Human Immunodeficiency Virus Treatment: Dynamic and Ever Evolving Subject Matter

Miruna-Maria Apetroaei  1 , Bruno Ștefan Velescu  1 , Marina Ionela Ilie Nedea  1 , Cristina Elena Dinu-Pîrvu  1 , Doina Drăgănescu  1 , Anca Ionela Fâcă  1   2 , Denisa Ioana Udeanu  1   2 , Andreea Letiția Arsene  1   2
Affiliations
Review

The Phenomenon of Antiretroviral Drug Resistance in the Context of Human Immunodeficiency Virus Treatment: Dynamic and Ever Evolving Subject Matter

Miruna-Maria Apetroaei et al. Biomedicines. .

Abstract

Human immunodeficiency virus (HIV) is a significant global health issue that affects a substantial number of individuals across the globe, with a total of 39 million individuals living with HIV/AIDS. ART has resulted in a reduction in HIV-related mortality. Nevertheless, the issue of medication resistance is a significant obstacle in the management of HIV/AIDS. The unique genetic composition of HIV enables it to undergo rapid mutations and adapt, leading to the emergence of drug-resistant forms. The development of drug resistance can be attributed to various circumstances, including noncompliance with treatment regimens, insufficient dosage, interactions between drugs, viral mutations, preexposure prophylactics, and transmission from mother to child. It is therefore essential to comprehend the molecular components of HIV and the mechanisms of antiretroviral medications to devise efficacious treatment options for HIV/AIDS.

Keywords: ART advancements; ART drug resistance; HIV genetic variability; antiretroviral drug resistance; global HIV/AIDS management.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
HIV-1 structure (created with Biorender.com).
Figure 2
Figure 2
HIV genome (adapted from [19]) (created with Biorender.com).
Figure 3
Figure 3
Drug classes used to treat HIV infection. Legend: NRTI—nucleoside reverse transcriptase inhibitors; NNRTI—non-nucleoside reverse transcriptase inhibitors; INSTI—integrase strand transfer inhibitors; PI—protease inhibitors.
Figure 4
Figure 4
Global demographic distribution of patients with access to antiretroviral therapy in 2023 (data from [105]).
Figure 5
Figure 5
WHO reports on antiretroviral medication resistance (Adapted from [106]).
Figure 6
Figure 6
WHO recommendations for limiting antiretroviral resistance (Adapted from [106]).
Figure 7
Figure 7
Causes leading to antiretroviral resistance (created with Biorender.com).
Figure 8
Figure 8
Drug classes and resistance mutations (created with Biorender.com).
See this image and copyright information in PMC

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