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VIDEO: Mutations, interactions influence development of drug resistance among patients with HIV
The role of mutations in the development of drug resistance among patients with HIV involves several factors, according to Alan Taege, MD, of the department of infectious disease at Cleveland Clinic.
According to Taege, it is important for clinicians to recognize that mutations resulting from drugs used to treat HIV “are random events.” Mutations may occur because of “the infidelity of the HIV replication mechanism,” as well as drug-drug interactions: “With our patients living longer, being older and having more comorbidities, we have to recall as well that they are on many other medications,” he said.
Taege categorizes mutations by the classes of drug regimens for HIV, including non-nucleoside reverse transcriptase inhibitors, nucleoside reverse-transcriptase inhibitors, protease inhibitors and integrase inhibitors. He reviews the importance of evaluating patients for these mutations and the tests available for identifying them.
“Keep in mind when you do your testing [that] the standard genotype today does not test for integrase mutations. … If that’s a consideration in your testing, you have to specifically request that assay,” Taege said.