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  • Clinical Implications
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The pharmacogenomics of HIV therapy

The Pharmacogenomics Journal volume 1, pages 243–253 (2001)Cite this article

AIDS turned 20 years old on 5 June 2001; it has to date claimed the lives of 21 million individuals, mostly within Africa.1 During the last 20 years, there has been remarkable progress in the therapy of HIV disease. At the beginning, all that was offered was prophylaxis and treatment of the opportunistic infections that are the hallmark of immunodeficiency. The first drug that was active against HIV, zidovudine (AZT), was licensed in 1987 in the US. Since then, advances have not only involved the development of new drugs, but also the use of these drugs in appropriate combinations. The use of so-called highly active antiretroviral therapy (HAART) since 1995 has led to a remarkable improvement in the prognosis of HIV disease:2 there has been a decrease in AIDS-related deaths, reduction in the use of drugs for opportunistic infections, and a decrease in the numbers of patients hospitalised with AIDS-related illnesses. HIV can now be classified as a chronic disease; until a cure is found, patients are likely to require life-long therapy. However, despite these undoubted advances, there are many issues that need to be resolved, including the problems associated with long-term efficacy and toxicity.

Pharmacogenomics has been widely hailed as a means to improve prescribing for all drugs.3 However, pharmacogenomics is likely to be particularly useful for drugs that have variable kinetics and dynamics, and a narrow therapeutic index. Anti-HIV drugs certainly fit this category. Although there are many issues that need to be handled in the next 20 years in the fight against HIV,1 individualisation of therapy through the use of pharmacogenomics has the potential to resolve some of the problems with currently available anti-HIV drugs as well as with the new drugs being developed. An additional area that needs to be considered in relation to HIV therapy is the genetic diversity of the virus itself. The purpose of this review is to highlight potential areas where pharmacogenomics may be of use in both maximising the efficacy and minimising the toxicity of antiretrovirals, in particular to:

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Acknowledgements

We gratefully acknowledge the support of the MRC, Wellcome Trust, AVERT, and the Pharmaceutical Industry (GlaxoSmithKline, Bristol Myers Squibb, Merk Sharpe Dohme, Roche).

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  1. Department of Pharmacology and Therapeutics, The University of Liverpool, Ashton Street, Liverpool, UK

    M Pirmohamed & D J Back

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  1. M Pirmohamed
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  2. D J Back
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Correspondence to M Pirmohamed.

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Pirmohamed, M., Back, D. The pharmacogenomics of HIV therapy. Pharmacogenomics J 1, 243–253 (2001). https://doi.org/10.1038/sj.tpj.6500069

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  • DOI: https://doi.org/10.1038/sj.tpj.6500069

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