Abstract: HIV-1 protease is one of the major antiviral targets in the treatment of patients infected with HIV-1. The nine FDA approved HIV-1 protease inhibitors were developed with extensive use of structure-based drug design, thus the atomic details of how the inhibitors bind are well characterized. From this structural understanding the molecular basis for drug resistance in HIV-1 protease can be elucidated. Selected mutations in response to therapy and diversity between clades in HIV-1 protease have altered the shape of the active site, potentially altered the dynamics and even altered the sequence of the cleavage sites in the Gag polyprotein. All of these interdependent changes act in synergy to confer drug resistance while simultaneously maintaining the fitness of the virus. New strategies, such as incorporation of the substrate envelope constraint to design robust inhibitors that incorporate details of HIV-1 protease’s function and decrease the probability of drug resistance, are necessary to continue to effectively target this key protein in HIV-1 life cycle.
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Ali, A.; Bandaranayake, R.M.; Cai, Y.; King, N.M.; Kolli, M.; Mittal, S.; Murzycki, J.F.; Nalam, M.N.; Nalivaika, E.A.; Özen, A.; Prabu-Jeyabalan, M.M.; Thayer, K.; Schiffer, C.A. Molecular Basis for Drug Resistance in HIV-1 Protease. Viruses 2010, 2, 2509-2535.
Ali A, Bandaranayake RM, Cai Y, King NM, Kolli M, Mittal S, Murzycki JF, Nalam MN, Nalivaika EA, Özen A, Prabu-Jeyabalan MM, Thayer K, Schiffer CA. Molecular Basis for Drug Resistance in HIV-1 Protease. Viruses. 2010; 2(11):2509-2535.
Ali, Akbar; Bandaranayake, Rajintha M.; Cai, Yufeng; King, Nancy M.; Kolli, Madhavi; Mittal, Seema; Murzycki, Jennifer F.; Nalam, Madhavi N.L.; Nalivaika, Ellen A.; Özen, Ayşegül; Prabu-Jeyabalan, Moses M.; Thayer, Kelly; Schiffer, Celia A. 2010. "Molecular Basis for Drug Resistance in HIV-1 Protease." Viruses 2, no. 11: 2509-2535.