HIV AND HIV MUTANTS E. Chigidi.ppt

,,Althoughmanyregimenslowerplasmaviralloadtobelowthelimitofdetectioninmostpatients,maintainingadurableresponseremainschallengingbecauseof(I)Adverseeffects(II)Longtermtoxicity(III)+-(a)Naturalselection(b)Transmissionofdrug-resistantvirusNaturalselection(a)HIVmakesmistakesduringcopyingandproducesvariants(b)Somevariantshavemutationsthatallowthevirustopartlyorevenfullresistananti--positivepeoplenowtakeanti-(a)DDI+3TC+NevirapineNRTI+NRTI+NevirapineOrD4T+3TC+NevirapineNRTI+NRTI+(paringtworegimensinvolving35patients:+emtricitabine+efavirenzNRTI+NRTI+NNRTI(12Patients)+3TC+efavirenzNRTI+NRTI+NNRTI(23Patients)OnRegimen1:2developedM184V/,exposuretoNNRTIefavirenzresultedinthedevelopmentofmutationK103Nin21outof35patientsOthermutationsweredetectedsuchasK101E,K103E,V108I/MV179D,Y188H,G190A/S/E,P225H,M230LInwesterncountrieswherechoiceforanti-HIVdrugsisgreaterandfinancialconstraintsarenotsoacute,therateofevolutionofdrugresistantstrainshas,toalargeextent,-SaharaAfricaisaffectedbyseveralbarriersnamely,anizational,physicala