Current ART, Virologic Failure and Implications for HIV Drug Resistance, 2nd Edition

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: closed (31 March 2025) | Viewed by 907

Special Issue Editor


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Guest Editor
Senior Director, Clinical Virology & Tranlsational Medicine, ViiV Healthcare, Durham, NC, USA
Interests: antiretroviral therapy (ART); HIV treatment; HIV drug resistance; drug discovery and development; novel HIV drug targets; functional HIV cure; clinical virology; HIV evolution and fitness; determinants of HIV pathogenesis; novel molecular mechanisms of HIV drug resistance; HIV immunogen design; translational medicine
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Special Issue Information

Dear Colleagues,

Virologic failure is the term used by physicians, clinicians, and clinical virologists to describe the failure to suppress and/or maintain virus replication at undetectable levels within a patient receiving antiretroviral therapy (ART). Identifying and managing the determinants of virological failure have an important role in facilitating high treatment success, improving quality of life for patients, and increasing survival rate from treatment failure(s). Whilst identifying the determinants of virologic failure is perceived as relatively straightforward with earlier versions of ART (especially in terms of drug resistance), there are few descriptions of virologic failure and acquired drug resistance with more contemporary ART. Understanding the concept and risk of virologic failure in terms of both conventional and contemporary ART is of paramount importance in order to make the next great leap in treating people living with HIV: permanent viral suppression without the need for lifelong medications.  

This Special Issue will accept many forms of manuscripts (original research papers, short communications, reviews, and opinion pieces) focusing on the current understanding of virological failure risk and the implications for drug resistance in the context of contemporary ART strategies.

Dr. Susan M. Schader
Guest Editor

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Keywords

  • antiretroviral therapy (ART)
  • HIV
  • AIDS
  • drug resistance
  • low level viremia (LLV)
  • very low level viremia (VLLV)
  • virologic failure (VF)
  • clinical failure
  • viral load (VL)
  • viral suppression
  • long-acting injectables (LAI)
  • pre-exposure prophylaxis (PrEP)
  • first-line ART
  • second-line ART
  • target detected
  • target not detected (TND)
  • viral blips
  • novel mechanisms of HIV drug resistance
  • acquired genotypic drug resistance
  • adherence
  • people living with HIV (PLWH)
  • management of people living with HIV (PLWH)
  • risk factors
  • genotype
  • phenotype
  • treatment efficacy

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Published Papers (1 paper)

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Research

8 pages, 193 KiB  
Article
First Reported Case of Integrase Strand Transfer Inhibitor Resistance in Suriname: Unusual Drug Resistance Mutations Following Exposure to Dolutegravir
by Rachel C. Sno, Gracia Culbard and Malti R. Adhin
Viruses 2025, 17(2), 245; https://doi.org/10.3390/v17020245 - 11 Feb 2025
Viewed by 658
Abstract
Contemporary ART as Dolutegravir (DTG) has significantly advanced antiretroviral therapy, but relatively few data are available on its impact on the emergence of HIV-1 drug resistance mutations (DRMs). Monitoring the emergence of INSTI-associated DRMs following the introduction of DTG in Suriname will provide [...] Read more.
Contemporary ART as Dolutegravir (DTG) has significantly advanced antiretroviral therapy, but relatively few data are available on its impact on the emergence of HIV-1 drug resistance mutations (DRMs). Monitoring the emergence of INSTI-associated DRMs following the introduction of DTG in Suriname will provide general insight and guide national HIV treatment strategies. All people living with HIV (PLHIV) in Suriname, for whom an INSTI drug resistance test was requested between September 2019 and February 2024 (n = 20), were included. HIV-1 integrase gene sequences were determined using Sanger sequencing. INSTI-associated mutations were identified using the Stanford HIV Drug Resistance Database program. The majority of the participants (66.7%) harbored HIV-1 subtype B, and 33.3% were B-recombinant forms. In addition to the INSTI wildtype, a strain was revealed carrying E157EQ and one person harbored a highly INSTI-resistant strain (E138K, G140S, Q148H and N155H). The emergence of a highly INSTI-resistant HIV-1 strain in Suriname, with unusual mutations for ART-experienced PLHIV exposed to DTG as the only INSTI, accentuates the need for continuous monitoring of the emergence of INSTI drug resistance mutations, not only to enable timely interventions and optimized treatment outcomes for PLHIV, but also to steer the decision making for ART protocols, especially for second generation INSTIs. Full article
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