Pharmacogenetics and its Role in HIV Therapy

Abstract

Humans exhibit considerable genetic variations (polymorphism) within their DNA sequence, and HLA is the most polymorphic human gene known, leading to a wide allelic variation in humans among different ethnicities, and populations. This wide variation in the human genes is responsible for the inter-individual variation in the amount and the amino acid sequences of the proteins that function as drug targets and also pharmacokinetic parameters such as absorption, distribution, metabolism, and elimination. The overall effect of the polymorphisms is how it can modify ways in which an individual metabolize, distribute, eliminate, and respond to a particular drug. Since its introduction, pharmacogenetics studies have begun identifying these differences in drug dispositions and effects, to improve both the safety and efficacy of drugs based on patients' genetic constitution. Pharmacogenetic testing for antiretroviral drugs are now available as a screening method to allow for a more individualized therapy, thereby minimizing toxicity and enhancing treatment success. These genetic screenings have been integrated into clinical practice in antiretroviral therapy. This paper reviews the history, concept, and role of pharmacogenetics in HIV therapy, including advancement in Antiretroviral therapy.