Journal of Environmental Pathology, Toxicology and Oncology

ISSN for PRINT: 0731-8898

For Online Access

Best Paper Award Selection - Editorial Board Site

2003, Volume22

Issue 3

92 pages

DOI: 10.1615/JEnvPathToxOncol.v22.i3

Issue price - $160.00

Roberto Patarca
Cordis Corporation, Miami Lakes, FL 33014

Alejandro Isava
Department of Pediatrics, Jackson Memorial Hospital, Miami, Florida, USA

Rafael Campo
Department of Internal Medicine, Jackson Memorial Hospital, Miami, Florida, USA

Nelson J. Rodriguez
E.M. Papper Laboratory of Clinical Immunology and Molecular Biology, University of Miami School of Medicine, Miami, Florida, USA

Enriqueta Nunez
E.M. Papper Laboratory of Clinical Immunology and Molecular Biology, University of Miami School of Medicine, Miami, Florida, USA

Michael Alter
E.M. Papper Laboratory of Clinical Immunology and Molecular Biology, University of Miami School of Medicine, Miami, Florida, USA

Margaret Marchette
E.M. Papper Laboratory of Clinical Immunology and Molecular Biology, University of Miami School of Medicine, Miami, Florida, USA

Mirtha M. Sanabia
E.M. Papper Laboratory of Clinical Immunology and Molecular Biology, University of Miami School of Medicine, Miami, Florida, USA

Charles Mitchell
Department of Pediatrics, Jackson Memorial Hospital, Miami, Florida, USA

Delia Rivera
Department of Pediatrics, Jackson Memorial Hospital, Miami, Florida, USA

Gwendolyn Scott
Department of Pediatrics, Jackson Memorial Hospital, Miami, Florida, USA

Dushyantha Jayaweera
Department of Internal Medicine, Jackson Memorial Hospital, Miami, Florida, USA

Jose Moreno
Department of Internal Medicine, Jackson Memorial Hospital, Miami, Florida, USA

Catherine Boulanger
Department of Internal Medicine, Jackson Memorial Hospital, Miami, Florida, USA

Michael Kolber
Department of Internal Medicine, Jackson Memorial Hospital, Miami, Florida, USA

Cindy W. Mask
Visible Genetics, Inc., Suwanee, Georgia, USA

Eduardo Meneses Sierra
Hospital Christus Muguerza, Saltillo, Coahuila CP, Mexico

Ricardo Vallejo
Department of Anesthesiology, Massachusetts General Hospital, Boston, Massachusetts, USA

J. Brian Page
E.M. Papper Laboratory of Clinical Immunology and Molecular Biology, University of Miami School of Medicine, Miami, Florida, USA

Nancy G. Klimas
E.M. Papper Laboratory of Clinical Immunology and Molecular Biology, University of Miami School of Medicine, Miami, Florida, USA

Mary Ann Fletcher
Departments of Medicine, and Microbiology and Immunology, University of Miami School of Medicine, E.M. Papper Laboratory of Clinical Immunology, P.O. Box 016960 (R-42), Miami, FL33101

Throughout most of the past century, physicians could offer patients no treatments for infections caused by viruses. The experience with treatment of infection by human immunodeficiency virus (HIV) has changed the way healthcare workers deal with viral infections and has triggered a growing rate of discovery and use of antiviral agents, the first fruits of the expanding genomics revolution. HIV treatment also provides an informative paradigm for pharmacogenomics because control of infection and its consequences is limited by the development of viral drug resistance and by host factors. This report summarizes studies published to date on the significance of testing of HIV-1 resistance to antiretroviral drugs. The only Food and Drug Administration-approved kit for HIV drug resistance testing by genotypic sequencing is commercially available through Visible Genetics, Inc. Genotyping sequencing alone is most likely an adequate test to assist in the therapeutic decision-making process for previous regimen failure, for treatment-naive patients in areas of high prevalence of transmitted resistant virus, and for pregnant women. However, in exceptional cases of highly complex mutation patterns and extensive cross-resistance, it may be useful to obtain a phenotype test, because that result may more easily identify drugs to which virus is least resistant. There are no published clinical trials results on the usefulness of the so-called virtual phenotype over genotypic sequencing alone. Not only has the paradigm of viral pharmacogenomics in the form of HIV genotypic sequencing been useful in treating other viral diseases, but it is also important to the real-life implementation of the growing discipline of genomics or molecular medicine. The application of this paradigm to the thousands of potential therapeutic targets that have become available through the various human genome projects will certainly gradually change the landscape of diagnosis and management of many diseases, including cancer.

DOI: 10.1615/JEnvPathToxOncol.v22.i3.40 Download article, 34 pages

Article price - $45.00

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