The dawn of precision medicine in HIV

state of the art of pharmacotherapy

Ying Mu, Sunitha Kodidela, Yujie Wang, Santosh Kumar, Theodore Cory

Research output: Contribution to journalReview article

Abstract

Introduction: Combination antiretroviral therapy (ART) reduces viral load to under the limit of detection, successfully decreasing HIV-related morbidity and mortality. Due to viral mutations, complex drug combinations and different patient response, there is an increasing demand for individualized treatment options for patients. Areas covered: This review first summarizes the pharmacokinetic and pharmacodynamic profile of clinical first-line drugs, which serves as guidance for antiretroviral precision medicine. Factors which have influential effects on drug efficacy and thus precision medicine are discussed: patients’ pharmacogenetic information, virus mutations, comorbidities, and immune recovery. Furthermore, strategies to improve the application of precision medicine are discussed. Expert opinion: Precision medicine for ART requires comprehensive information on the drug, virus, and clinical data from the patients. The clinically available genetic tests are a good starting point. To better apply precision medicine, deeper knowledge of drug concentrations, HIV reservoirs, and efficacy associated genes, such as polymorphisms of drug transporters and metabolizing enzymes, are required. With advanced computer-based prediction systems which integrate more comprehensive information on pharmacokinetics, pharmacodynamics, pharmacogenomics, and the clinically relevant information of the patients, precision medicine will lead to better treatment choices and improved disease outcomes.

Original languageEnglish (US)
Pages (from-to)1581-1595
Number of pages15
JournalExpert Opinion on Pharmacotherapy
Volume19
Issue number14
DOIs
StatePublished - Sep 22 2018

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Precision Medicine
HIV
Drug Therapy
Pharmaceutical Preparations
Pharmacogenetics
Pharmacokinetics
Viruses
Mutation
Expert Testimony
Drug Combinations
Therapeutics
Viral Load
Limit of Detection
Comorbidity
Morbidity
Mortality
Enzymes
Genes

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)

Cite this

The dawn of precision medicine in HIV : state of the art of pharmacotherapy. / Mu, Ying; Kodidela, Sunitha; Wang, Yujie; Kumar, Santosh; Cory, Theodore.

In: Expert Opinion on Pharmacotherapy, Vol. 19, No. 14, 22.09.2018, p. 1581-1595.

Research output: Contribution to journalReview article

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