Despite the success of antiretroviral drugs, therapy of HIV/AIDS still suffers from severe drawbacks because of undesired consequences of therapy. The major undesired consequence is resistance which renders individual drugs and complete drug classes ineffective. 70-80% of HIV-infected patients undergoing resistance testing carry drug resistant virus and 10% of new transmissions involve resistant or multi-resistant viruses. With the roll out of HIV therapy in developing countries, drug resistance will become a worldwide problem, while resistance development in non-subtype B strains of HIV (dominant in developing countries) is largely inferred from results obtained with subtype B viruses. Protease inhibitors (PI) have been a key factor in the success of HIV therapy, but as with all clinically used drugs resistance has been observed.
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