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Resisting Resistance: Maximizing the Durability of Antiretroviral Therapy

1998; American College of Physicians; Volume: 128; Issue: 11 Linguagem: Inglês

10.7326/0003-4819-128-11-199806010-00017

1539-3704

Jon H. Condra,

HIV/AIDS Research and Interventions

Editorials1 June 1998Resisting Resistance: Maximizing the Durability of Antiretroviral TherapyJon H. Condra, PhDJon H. Condra, PhDMerck Research Laboratories; West Point, PA 19486Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-11-199806010-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In the past 3 years, a veritable explosion of data has yielded new insight into the biology of HIV infection and the pathogenesis of AIDS. It is now well known that HIV infection, even during its long asymptomatic phase, is characterized by high rates of viral replication and destruction of CD4+ cells, which ultimately lead to immune deficiency, AIDS-defining illnesses, and death. Consequently, inhibition of viral replication has assumed primary importance in the control of AIDS.Simultaneously, a new class of potent antiviral drugs, HIV protease inhibitors, was introduced. Protease inhibitors have proven, for the first time, that potent, sustained ...References1. Gulick RM, Mellors JW, Havlir D, Eron JJ, Gonzalez C, McMahon D, et al. Treatment with indinavir, zidovudine, and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy. N Engl J Med. 1997; 337:734-9. Google Scholar2. Gulick RM, Mellors JW, Havlir D, Eron JJ, Gonzalez C, McMahon D, et al. Indinavir (IDV), zidovudine (ZDV) and lamivudine (3TC): concurrent or sequential therapy in ZDV- experienced patients [Abstract]. Abstracts of 37th Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington, DC: American Society for Microbiology; 1997:I-89. Google Scholar3. Cameron DW, Heath-Chiozzi M, Kravcik S, Mills R, Potthoff A. Henry D. Prolongation of life and prevention of AIDS complications in advanced HIV immunodeficiency with ritonavir: update [Abstract]. Int Conf AIDS. 1996; 11:24. Google Scholar4. 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In vivo resistance to a human immunodeficiency virus type 1 proteinase inhibitor: mutations, kinetics, and frequencies. J Infect Dis. 1996; 173:1379-87. Google Scholar14. Patick AK, Mo H, Markowitz M, Appelt K, Wu B, Musick L, et al. Antiviral and resistance studies of AG1343, an orally bioavailable inhibitor of human immunodeficiency virus protease. Antimicrob Agents Chemother. 1996; 40:292-7. Google Scholar15. Tisdale M, Myers RE, Maschera B, Parry NR, Oliver NM, Blair ED. Cross-resistance analysis of human immunodeficiency virus type 1 variants individually selected for resistance to five different protease inhibitors. Antimicrob Agents Chemother. 1995; 39:1704-10. Google Scholar16. Vacca JP, Condra JH. Clinically effective HIV-1 protease inhibitors. Drug Discovery Today. 1997; 2:261-72. Google Scholar17. Deeks S, Loftus R, Cohen P, Chin S, Grant R. Incidence and predictors of virologic failure to indinavir (IDV) or/and ritonavir (RTV) in an urban health clinic [Abstract]. Abstracts of 37th Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington, DC: American Society for Microbiology; 1997:LB-2. Google Scholar18. Shafer RW, Winters MA, Palmer S, Merigan TC. Multiple concurrent reverse transcriptase and protease mutations and multidrug resistance of HIV-1 isolates from heavily treated patients. Ann Intern Med. 1998; 128:906-911. Google Scholar19. Condra JH, Holder DJ, Graham DJ, Shivaprakash M, Laird DT, Schleif WA, et al. Genotypic or phenotypic susceptibility testing may not predict clinical responses to indinavir [Abstract]. Abstracts of the International Workshop on HIV Drug Resistance, Treatment Strategies and Eradication. Antiviral Therapy Quarterly. San Diego: University of California, San Diego; 1997:31-2. Google Scholar20. Hertogs K, Mellors JW, Schel P, Van Cauwenberghe A, Larder B, Kemp S, et al. Patterns of cross-resistance among protease inhibitors in 483 clinical HIV-1 isolates [Abstract]. Program and Abstracts of the 5th Conference on Retroviruses and Opportunistic Infections, 1-5 February 1998, Chicago. Alexandria, VA: Foundation for Retrovirology and Human Health; 1998:153. Google Scholar Author, Article, and Disclosure InformationAuthors: Jon H. Condra, PhDAffiliations: Merck Research Laboratories; West Point, PA 19486Corresponding Author: Jon H. Condra, PhD, Department of Antiviral Research, Merck & Co., Inc., WP26-339, West Point, PA 19486. 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Goldie, MD, MPH, Milton C. Weinstein, PhD, Karen M. Kuntz, ScD, and Kenneth A. Freedberg, MD, MScAnal Intraepithelial Neoplasia (AIN) 1 June 1998Volume 128, Issue 11Page: 951-954KeywordsAIDSAmino acidsClinical trialsDrugsGeneticsHIVMutationProtease inhibitorsReverse transcriptase inhibitorsViral replication ePublished: 15 August 2000 Issue Published: 1 June 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...