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This version was published on September 1, 2007
Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 6, No. 3, 188-197 (2007)
DOI: 10.1177/1545109707300683
© 2007 SAGE Publications

Transmitted Resistance: An Overview and Its Potential Relevance to the Management of HIV-Infected Persons in Resource-Limited Settings

Babafemi O. Taiwo, MD

Division of Infectious Diseases at Northwestern University Feinberg School of Medicine, Chicago, IL, b-taiwo{at}northwestern.edu

Robert Murphy, MD

Division of Infectious Diseases at Northwestern University Feinberg School of Medicine, Chicago, IL

Transmitted resistance has become an important clinical problem in developed countries with long histories of antiretroviral use. In resource-limited settings, it is a foreseeable, if not insidiously emerging, issue. Any transmission route or currently approved antiretroviral drug may be involved. The clinical relevance of polymorphisms that commonly occur at sites known to be associated with resistance, and peculiarities of the non-B subtypes, are incompletely understood. Adverse clinical consequences that have been demonstrated with transmitted resistance include an increased risk of failing initial therapy and further development of resistance. Although treatment outcomes can be optimized by baseline resistance testing and virologic monitoring, these are impractical in most resource-limited settings at this time. The scale and impact of transmitted resistance can probably be reduced by comprehensive prevention and management strategies. Equally germane are epidemiological and clinical studies to extend understanding of the dynamics, clinical implications, and management of transmitted resistance.

Key Words: transmitted resistance • resource limited • mutation


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