Gene profiling in HIV/AIDS patients: impacts on therapy

Abstract

HIV types 1 and 2 have become global in their dispersion. Over 30 million people are living with extremely heterogeneous HIV types, subtypes and circulating recombinant forms with enormously different prevalence rates by global region. As HIV strains have diverged evolutionarily, HIV gene profiles have become more important for the development of new diagnostic kits, antiviral drugs and vaccines. No significant differences in disease progression between HIV subtypes exist, although individuals infected with HIV-1 subtype A show a slower progression of infection than people infected with subtype D. Available serological and molecular commercial diagnostic kits are suitable for the detection of HIV-1 group M and O, and HIV-2. All HIV subtypes display similar susceptibilities to antiretroviral drugs, and most of the drug-resistance mutation sites of protease and reverse transcriptase are suitable to assess drug resistance in B and non-B viruses. An effective AIDS vaccine requires generation of neutralizing antibodies with a potent and broadly cross-reactive response against primary isolates of the viruses but this has not been achieved to date owing to the genetic divergence of multiple HIV strains. In conclusion, owing to dynamic HIV strain evolution, we need to monitor HIV gene profiles continuously and should evaluate their impacts on clinical therapy, efficacy of new drugs and vaccine development.