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Novel mechanisms of HIV protease inhibitor resistance

Nijhuis, Moniquea; van Maarseveen, Noortje Ma; Verheyen, Jensb; Boucher, Charles ABa,c

Current Opinion in HIV and AIDS: November 2008 - Volume 3 - Issue 6 - p 627–632
doi: 10.1097/COH.0b013e3283136cd9
HIV protease inhibitors: Edited by Jon Schapiro and John Erickson

Purpose of review Several alternative mechanisms that cause protease inhibitor resistance have been proposed. A summary of the proposed mechanisms and the status regarding their clinical relevance is given.

Recent findings At this moment only changes in the cleavage sites of protease (either alone or in the background of protease mutations) have been associated with phenotypic changes in IC50 and virological failure.

Summary Further studies are necessary to unravel the mechanism, the clinical relevance and potential effect of transmission of these cleavage site changes.

aDepartment of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands

bInstitute of Virology, University of Cologne, Cologne, Germany

cDepartment of Virology, Erasmus Medical Center, Rotterdam, The Netherlands

Correspondence to Charles Boucher, Department of Medical Microbiology, University Medical Center Utrecht, Heidelberglaan 100 (HP G04.614), 3584 CX Utrecht, The Netherlands Tel: +31 88 755 6526; fax: +31 88 755 5426; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.