Pharmacogenomics in HIV Disease

Pharmacogenetics holds promise in HIV treatment because of the complexity and potential toxicity of multidrug therapies that are prescribed for long periods. However, there has been limited success with the current approach, in which one or few candidate genes are examined for a limited number of allelic variants. A change in paradigm emerges from the availability of the HapMap, the wealth of data on less common genetic polymorphisms, and new genotyping technology. This chapter presents a comprehensive review of the existing literature on pharmacogenetic determinants of antiretroviral drug exposure and of drug toxic-ity, as well as on genetic markers associated with the rate of disease progression. In addition, this chapter discusses current opportunities in the clinical arena, as well as issues on genetics in HIV drug development. It is expected that larger-scale comprehensive genome approaches will profoundly change the landscape of knowledge in the future.