( f adherence. This happens because only ...)Viral 'fitness' explains different resistance patterns to aids drugs

f adherence. This happens because only a single mutation is required to create high-level NNRTI resistance and these mutations have little impact on the virus's ability to replicate. PI-resistant virus, in contrast, requires multiple mutations, each of which significantly weakens the ability of the virus to replicate. These PI-resistant viruses only emerge, therefore, when challenged with high concentrations of drug.

Overall, study findings showed that NNRTI resistance was found less often than PI resistance among patients who took the pills as directed.

"We believe that when new drug classes are developed, more attention should be given in defining how virologic fitness determines how different patterns of taking medications may lead to resistance" said Steven Deeks, MD, associate professor of medicine at UCSF's Positive Health Program at SFGHMC and senior author on the study.

Both NNRTIs and non-boosted protease inhibitors are potent antiretroviral drugs (ARVs) with demonstrated effectiveness in suppressing the HIV virus when taken in combination with other ARVs at high levels of pill-taking as directed. The standard combination therapy usually includes either one NNRTI or protease inhibitor (non-boosted or boosted with a small amount of another potent PI) and two different antiretrovirals from the nucleoside reverse transcriptase inhibitor class.

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Source:University of California - San Francisco


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