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HIV tropism and its implications for antiretroviral therapy
Carmen L. Chiriac, Marta A. Fodor, Nina I. Şincu
Abstract: Viral tropism defines the feature of HIV isolates to use a certain CCR5, CXCR4 coreceptor in order to enter CD4 positive, receptor cells. The dynamics of the HIV tropism plays a major role in the pathogenesis of the HIV infection and influences the progression of the disease. HIV tropism correlates with the epidemiology of HIV-1 subtypes and can be modified by the antiretroviral complex therapy. Coreceptor antagonists CCR5 (CXC4) represent a new generation of molecules used in the therapy of HIV infection, in multi-experienced patients as well as in naïve individuals. Maraviroc is the only drug from the class of coreceptor antagonists approved for the treatment of CCR5 tropic HIV-1 infected patients. In order to determine the susceptibility of an HIV-1 population to CCR5 antagonists, viral tropism testing is indispensable. Several phenotype and genotype tests were developed to identify the tropism of the HIV-1 isolates. The clinically approved method is Trofile, certified according to the specifications of the Clinical Laboratory Improvement Amendments (CLIA).
Keywords: CCR5,CXCR4 coreceptors,HIV-1 tropism,coreceptor antagonists
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