@article{fdi:010037889,
  title = {{P}harmacogenetics of antiretroviral drugs for the treatment of {HIV}-infected patients : {A}n update},
  author = {{C}ressey, {T}im {R}. and {L}allemant, {M}arc},
  abstract = {{H}ighly active antiretroviral therapy ({HAART}), a combination of at least three antiretroviral drugs, has dramatically improved the prognosis of {HIV}/{AIDS}. {H}owever, viral replication under therapy can lead to the selection of drug resistant viruses and subsequent virologic failure. {W}hile poor adherence is likely to be the main cause of treatment failure, individual pharmacokinetic variability can also play an important role. {D}rug-drug interactions, drug-food interactions, sex, age, renal/hepatic function and pregnancy are all sources of pharmacokinetic variability. {R}ecent pharmacogenetic studies of antiretroviral drugs reported the influence of several genetic polymorphisms on antiretroviral drug exposure, toxicity and response to treatment. {I}nitially, a single nucleotide polymorphism ({SNP}) in exon 26 ({C}3435{T}) of the multi-drug transporter gene ({MDR} 1) was reported to be associated with low antiretroviral plasma drug levels but good initial immunological response; however, conflicting results have since been reported. {S}everal studies on efavirenz, a commonly used antiretroviral drug, have reported higher plasma exposure and early side effects with the homozygous variant of the hepatic cytochrome {P}450 enzyme {CYP}2136 {G}516{T} polymorphism, which are more frequently found in {A}frican-{A}merican subjects. {H}owever, despite its association with efavirenz exposure this polymorphism was not associated with time to virologic or toxicity-related failure. {G}enetic analysis has also proven to be a valuable predictor of antiretroviral drug hypersensitivity reactions; genetic screening of patients prior to initiation of specific antiretrovirals has proven to reduce the incidence of drug hypersensitivity in certain settings. {T}he reasons for antiretroviral treatment failure are multi-factorial but as the individualization of {HAART} increases understanding the influence of specific genotypes on treatment success and toxicity could further optimize these life-saving treatments.},
  keywords = {pharmacogenomics ; {HIV} ; antiretroviral ; {MDR}1 ; {CYP}2{B}6 ; hypersensitivity reactions},
  journal = {{I}nfection {G}enetics and {E}volution},
  volume = {7},
  numero = {2},
  pages = {333--342},
  ISSN = {1567-1348},
  year = {2007},
  DOI = {10.1016/j.meegid.2006.08.004},
  URL = {http://www.documentation.ird.fr/hor/fdi:010037889},
}