• Mark A Wainberg, Thibault Mesplède, and Francois Raffi.
• Departments of Medicine and Microbiology, Jewish General Hospital, McGill University, Montreal, QC, Canada. mark.wainberg@mcgill.ca.
• Bmc Med. 2013 Nov 22; 11: 249.

BackgroundThe HIV integrase inhibitor, Dolutegravir (DTG), was recently approved by the Food and Drug Administration in the United States and is the only HIV drug that has not selected for resistance mutations in the clinic when used as part of first-line therapy. This has led to speculation that DTG might have a higher genetic barrier for the development of drug resistance than the other compounds that are used in therapy.DiscussionIn this Opinion article, we speculate that this is due to greatly diminished replication capacity on the part of viruses that might become resistant to DTG when the drug is used in initial therapy and that DTG might be able to be used in HIV prevention and eradication strategies. We also note that no compensatory mutation that might restore viral replication fitness to HIV in the aftermath of the appearance of a single drug resistance mutation has yet to be observed.SummaryDTG is a valuable addition to the anti-HIV armamentarium of drugs and its long-term utility may potentially exceed its obvious use in treatment of HIV disease.

21 keywords...

hide…