The clinical utility of pharmacogenetic associations in HIV therapy

Abstract

The introduction of HAART has had a remarkably positive impact on HIV patient survival. However individual genetic variability can significantly affect patient response to drugs. A number of associations between genotype and antiretroviral response have been identified, none more important than that of HLA-B*5701 and abacavir hypersensitivity. The abacavir example highlights the quality of evidence required for a pharmacogenetic test to be accepted into clinical practice. This review summarizes the current, confirmed pharmacogenetic associations in HIV therapy and provides an assessment of their clinical utility based on the evidence to date. True individualization of antiretroviral treatment remains a distant hope. Nevertheless, with careful consideration of the requirements for a pharmacogenetic test to gain acceptance into clinical practice and advanced scientific techniques we may soon see rapid development in the utilization of pharmacogenetics in HIV therapy.