Adherence to antiretroviral therapy affects the pharmacokinetics of antiviral drugs and activates a cascade of events ultimately leading to therapeutic success or failure. An optimal adherence usually affords minimal rounds of virus replication and rare spontaneous mutations, which are unable to be fixed in the genome because of the competition of wild-type (more fit) strains. Therefore, adherence-based therapeutic success is mostly accompanied by the prevalence of wild-type strains. In case of poor adherence, virus replication is substantial, and mutations randomly occurring tend to be fixed within the genome. Under these conditions, mutated-resistant strains will outgrow wild-type virus (sensitive to antivirals and thereby unable to compete enough with resistant strains for cellular targets): thus, therapeutic failure occurs, and mutated resistant strains are predominant. In the case of very low or absent adherence, virologic failure occurs, although wild-type virus (whose replication is not significantly affected by antivirals) is not outgrown by mutated strains randomly produced but unable to be fixed within the genome. Taken together, these events and their consequences strongly support the relevance of a tight and continuous monitoring of adherence to antiretroviral drugs to prevent the risk of development of mutated strains often cross-resistant to the majority of antiretroviral drugs currently available.

Perno, C.f., CECCHERINI SILBERSTEIN, F., De Luca, A., Cozzi Lepri, A., Gori, C., Cingolani, A., et al. (2002). Virologic correlates of adherence to antiretroviral medications and therapeutic failure. JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 31 Suppl 3, S118-S118-22.

Virologic correlates of adherence to antiretroviral medications and therapeutic failure

PERNO, CARLO FEDERICO;CECCHERINI SILBERSTEIN, FRANCESCA;Bellocchi, M;
2002-12-15

Abstract

Adherence to antiretroviral therapy affects the pharmacokinetics of antiviral drugs and activates a cascade of events ultimately leading to therapeutic success or failure. An optimal adherence usually affords minimal rounds of virus replication and rare spontaneous mutations, which are unable to be fixed in the genome because of the competition of wild-type (more fit) strains. Therefore, adherence-based therapeutic success is mostly accompanied by the prevalence of wild-type strains. In case of poor adherence, virus replication is substantial, and mutations randomly occurring tend to be fixed within the genome. Under these conditions, mutated-resistant strains will outgrow wild-type virus (sensitive to antivirals and thereby unable to compete enough with resistant strains for cellular targets): thus, therapeutic failure occurs, and mutated resistant strains are predominant. In the case of very low or absent adherence, virologic failure occurs, although wild-type virus (whose replication is not significantly affected by antivirals) is not outgrown by mutated strains randomly produced but unable to be fixed within the genome. Taken together, these events and their consequences strongly support the relevance of a tight and continuous monitoring of adherence to antiretroviral drugs to prevent the risk of development of mutated strains often cross-resistant to the majority of antiretroviral drugs currently available.
15-dic-2002
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA
English
Con Impact Factor ISI
Virus Replication; Treatment Failure; Drug Resistance, Viral; Anti-HIV Agents; Patient Compliance; Humans
Perno, C.f., CECCHERINI SILBERSTEIN, F., De Luca, A., Cozzi Lepri, A., Gori, C., Cingolani, A., et al. (2002). Virologic correlates of adherence to antiretroviral medications and therapeutic failure. JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 31 Suppl 3, S118-S118-22.
Perno, Cf; CECCHERINI SILBERSTEIN, F; De Luca, A; Cozzi Lepri, A; Gori, C; Cingolani, A; Bellocchi, M; Trotta, M; Piano, P; Forbici, F; Scasso, A; Vul...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/52219
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