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Int J STD AIDS 2009;20:145-151
doi:10.1258/ijsa.2008.008369
© 2009 Royal Society of Medicine Press

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Reviews

The impact of pharmacogenetics on HIV therapy

T W Mahungu DTM&H MRCP  * {dagger}, M A Johnson MD FRCP *, A Owen MSc PhD {dagger} and D J Back PhD {dagger}

* Department of HIV Medicine, Royal Free NHS Trust, Pond Street, London NW3 2QG; {dagger} Department of Pharmacology and Therapeutics, University of Liverpool, 70 Pembroke Place, Liverpool L69 3GF, UK

Correspondence to: Dr Tabitha W. Mahungu Email: wambura{at}gmail.com

The use of highly active antiretroviral therapy in the treatment of HIV infection has resulted in significant reductions in mortality and morbidity worldwide. However, there is considerable interindividual variability in patient outcomes in terms of drug disposition, drug efficacy and adverse events. The basis of these differences is multifactorial, but host genetics are believed to play a significant part. To date, most attempts to explain this variability have focused on isolated single nucleotide polymorphisms. The most exciting development to date is the discovery of human leukocyte antigen subtype B*5701 (HLA B*5701) as a strong predictor of the abacavir hypersensitivity reaction. There is a gradual move away from single candidate gene analyses towards a high throughput whole genome approach. These studies must be performed on well characterized cohorts and reported associations must be validated in independent, ethnically diverse populations.

Key Words: HIV • HAART • pharmacogenetics • pharmacokinetics • pharmacodynamics


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