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JAC Advance Access originally published online on January 14, 2003
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Journal of Antimicrobial Chemotherapy (2003) 51, 229-240
© 2003 The British Society for Antimicrobial Chemotherapy

Review Article

Impact of clade diversity on HIV-1 virulence, antiretroviral drug sensitivity and drug resistance

Shalom Spira, Mark A. Wainberg*, Hugues Loemba, Dan Turner and Bluma G. Brenner

McGill University AIDS Centre, Lady Davis Institute, Jewish General Hospital, 3755 Cote Ste-Catherine Road, Montreal, Quebec, Canada H3T 1E2

HIV-1 infection is characterized by genetic diversity wherein distinct viral subtypes (clades A, B, C, D, E, F, G, K and O) are expanding in different geographical regions. This article deals with the topic of HIV-1 subtype diversity in the context of sensitivity to antiretroviral drugs, drug resistance and viral fitness. Increasing evidence suggests that all clades of HIV probably display similar sensitivity to antiviral drugs. However, viruses from some subtypes and/or geographical regions may have a greater propensity to develop resistance against certain drugs than do other viral variants. In addition, differences in regard to replication capacity or fitness may exist among various HIV subtypes and differences in this regard may potentially become magnified under conditions of drug resistance. Immunological pressures may also play an important role in the evolution of viral subtypes that may impact on ultimate drug resistance profiles.

Keywords: HIV, clade, resistance

* Corresponding author. Tel: +1-514-340-8260; E-mail: mark.wainberg{at}mcgill.ca


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