Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virology. Aug 12, 2015; 4(3): 169-177
Published online Aug 12, 2015. doi: 10.5501/wjv.v4.i3.169
Can antiretroviral therapy be tailored to each human immunodeficiency virus-infected individual? Role of pharmacogenomics
Victor Asensi, Julio Collazos, Eulalia Valle-Garay
Victor Asensi, Infectious Diseases-HIV Unit, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, 33013 Oviedo, Spain
Julio Collazos, Infectious Diseases Unit, Hospital de Galdácano, 48960 Vizcaya, Spain
Eulalia Valle-Garay, Biochemistry and Molecular Biology Department, Oviedo University School of Medicine, 33006 Oviedo, Spain
Author contributions: All authors contributed to this paper.
Conflict-of-interest statement: The authors do not have any conflict of interest related to this paper.
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: Victor Asensi, MD, PhD, Infectious Diseases-HIV Unit, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Avenida de Roma s/n, 33013 Oviedo, Spain. vasensia@gmail.com
Telephone: +34-985-108000-36442
Received: January 15, 2015
Peer-review started: January 16, 2015
First decision: April 27, 2015
Revised: May 8, 2015
Accepted: June 9, 2015
Article in press: June 11, 2015
Published online: August 12, 2015
Processing time: 210 Days and 9.4 Hours
Abstract

Pharmacogenetics refers to the effect of single nucleotide polymorphisms (SNPs) within human genes on drug therapy outcome. Its study might help clinicians to increase the efficacy of antiretroviral drugs by improving their pharmacokinetics and pharmacodynamics and by decreasing their side effects. HLAB*5701 genotyping to avoid the abacavir-associated hypersensitivity reaction (HSR) is a cost-effective diagnostic tool, with a 100% of negative predictive value, and, therefore, it has been included in the guidelines for treatment of human immunodeficiency virus (HIV) infection. HALDRB*0101 associates with nevirapine-induced HSR. CYP2B6 SNPs modify efavirenz plasma levels and their genotyping help decreasing its central nervous system, hepatic and HSR toxicities. Cytokines SNPs might influence the development of drug-associated lipodystrophy. APOA5, APOB, APOC3 and APOE SNPs modify lipids plasma levels and might influence the coronary artery disease risk of HIV-infected individuals receiving antiretroviral therapy. UGT1A1*28 and ABCB1 (MDR1) 3435C > T SNPs modify atazanavir plasma levels and enhance hyperbilirubinemia. Much more effort needs to be still devoted to complete large prospective studies with multiple SNPs genotyping in order to reveal more clues about the role played by host genetics in antiretroviral drug efficacy and toxicity.

Keywords: Pharmacogenomics; Pharmacokinetics; Antiretroviral drugs; Adverse effects; Human immunodeficiency virus infection; Single nucleotide polymorphisms

Core tip: Pharmacogenetics may play an important role in the near future for the treatment of human immunodeficiency virus-infection, as exemplified by the HLAB*5701 genotyping to prevent the abacavir-associated hypersensitivity reaction. Diverse other single nucleotide polymorphisms have been described as related to certain pharmacokinetic characteristics and adverse effects of antiretroviral drugs. In this Editorial we summarize the current knowledge on this rapidly evolving field.