What kind of mutations reduce susceptibility to specific drugs in HIV?

Primary resistance mutations are specific changes in the viral genome that enable HIV to withstand the effects of certain antiretroviral medications. These mutations often occur in the genes that encode for viral proteins targeted by these drugs, allowing the HIV virus to replicate even in the presence of medication.

When an individual is infected with a strain of HIV that has these primary resistance mutations, the effectiveness of the standard treatment regimens can be significantly decreased. Identifying these mutations is crucial for optimizing treatment strategies and ensuring that patients receive the most effective antiretroviral therapy from the outset.

While non-specific mutations, secondary resistance mutations, and silent mutations can also play roles in the resistance landscape of HIV, they do not directly reduce susceptibility to specific drugs in the same manner that primary resistance mutations do. Non-specific mutations may not have any significant impact on drug efficacy, secondary mutations might arise as a result of the viral replication under drug pressure, but they generally are not the initial changes that directly confer resistance, and silent mutations do not affect the protein coding and therefore do not influence drug susceptibility.