Pharmacogenetic associations with cytochrome P450 in antiretroviral therapy: what does the future hold?

Expert Opin Drug Metab Toxicol. 2018 Jun;14(6):601-611. doi: 10.1080/17425255.2018.1478964. Epub 2018 May 28.

Abstract

Several antiretroviral drugs used to treat infection with the human immunodeficiency virus (HIV) are substrates of enzymes belonging to the cytochrome P450 (CYP) superfamily, which are polymorphically expressed. It may therefore be useful to take into account the genetic variation in these enzymes to predict the likelihood of anti-HIV treatment success, toxicity and the potential for drug-drug interactions. Areas covered: In this manuscript, the authors discuss the current state of knowledge regarding pharmacogenetic associations between CYP and all major antiretrovirals, as well as the importance of these associations. Expert opinion: While many pharmacogenetic associations for CYP have been described in the literature, replication studies are sometimes lacking. The implementation of this knowledge in clinical practice also remains difficult. Further efforts are required both to expand this field of knowledge and to enable its use in everyday clinical practice.

Keywords: Antiretroviral; cytochrome P450; human immunodeficiency virus; non-nucleoside reverse transcriptase inhibitor; pharmacogenetics; pharmacogenomics; protease inhibitor.

Publication types

  • Review

MeSH terms

  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / pharmacokinetics
  • Cytochrome P-450 Enzyme System / genetics*
  • Cytochrome P-450 Enzyme System / metabolism
  • Drug Interactions
  • Genetic Variation
  • HIV Infections / drug therapy
  • Humans
  • Pharmacogenetics*

Substances

  • Anti-HIV Agents
  • Cytochrome P-450 Enzyme System