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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virology. Aug 12, 2015; 4(3): 198-208
Published online Aug 12, 2015. doi: 10.5501/wjv.v4.i3.198
Pharmacogenetics as a tool to tailor antiretroviral therapy: A review
Antonio Aceti, Laura Gianserra, Lara Lambiase, Alfredo Pennica, Elisabetta Teti
Antonio Aceti, Laura Gianserra, Lara Lambiase, Alfredo Pennica, Elisabetta Teti, Clinical Infectious Diseases, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest statement: The authors declare that there is no actual or potential conflict of interest in relation to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Antonio Aceti, Professor, Clinical Infectious Diseases, Sant’Andrea Hospital, Sapienza University of Rome, via Grottarossa 1035-1039, 00189 Rome, Italy. antonio.aceti@uniroma1.it
Telephone: +39-06-33775817 Fax: +39-06-33775073
Received: September 27, 2014
Peer-review started: September 28, 2014
First decision: December 17, 2014
Revised: July 8, 2015
Accepted: July 24, 2015
Article in press: July 27, 2015
Published online: August 12, 2015
Processing time: 319 Days and 10.9 Hours
Abstract

Highly active antiretroviral therapy (HAART) has substantially changed human immunodeficiency virus (HIV) infection from an inexorably fatal condition into a chronic disease with a longer life expectancy. This means that HIV patients should receive antiretroviral drugs lifelong, and the problems concerning with a chronic treatment (tolerability, side effects, adherence to treatment) have now become dominant. In this context, strategies for the treatment personalization have taken a central role in optimizing the therapeutic response and prevention of adverse drug reactions. In this setting, the study of pharmacogenetics features could be a very useful tool in clinical practice; moreover, nowadays the study of genetic profiles allows optimizations in the therapeutic management of People Living With HIV (PLWH) through the use of test introduced into clinical practice and approved by international guidelines for the adverse effects prevention such as the genetic test HLA-B*5701 to detect hypersensitivity to Abacavir. For other tests further studies are needed: CYP2B6 516 G > T testing may be able to identify patients at higher risk of Central Nervous System side effects following standard dosing of Efavirenz, UGT1A1*28 testing before initiation of antiretroviral therapy containing Atazanavir may aid in identifying individuals at risk of hyperbilirubinaemia. Pharmacogenetics represents a ​​research area with great growth potential which may be useful to guide the rational use of antiretrovirals.

Keywords: Pharmacogenetics; Pharmacogenomics; Single nucleotide polymorphism; Pharmacokinetics; Highly active antiretroviral therapy; Polymorphism; Phenotype; Pharmacodynamic

Core tip: The wide availability of drugs and therapeutic regimens for the human immunodeficiency virus infection treatment and the presence of associated adverse effects related to interindividual variability leads the clinician to look for an individualized therapy as much as possible. Pharmacogenetics can provide useful tools for this purpose and can propose models of genetics tests that, however, need to be further studied. This paper aim is to provide a critical and understandable review of published literature and a guidance about future prospects in this field.