Harnessing pharmacogenomics to tackle resistance to the "nucleoside reverse trancripatse inhibitor" backbone of highly active antiretroviral therapy in resource limited settings

BACKGROUND: The sustainable use of HAART within the sub-Saharan and other developing world settings faces the emerging challenge of drug resistance. Nucleoside reverse transcriptase inhibitors (NRTI) form the backbone of HAART and preserving their "antiviral efficacy" is thus critical to sustainable HAART use. METHODS: A systematic review of the "mechanisms of evolution" of resistance to NRTI at the HIV genome level, and the phenotypic manifestations on drug pharmacokinetics was done. CONCLUSION: This paper provides an evidence based account of how the knowledge of pharmacogenomics may be exploited to tackle NRTI resistance within limited resource.