Pharmacogenetics in HIV therapy: a review of key biomarkers, regulatory annotations, and clinical dosing guidelines.

Abstract

Pharmacogenetics is pivotal in modern HIV management, facilitating the transition from the traditional "one-size-fits-all" model toward personalized precision medicine. By analyzing how unique genetic profiles influence pharmacological responses, clinicians can maximize therapeutic efficacy while minimizing toxicities and adverse drug reactions. Given the high interindividual variability in antiretroviral drug exposure and the necessity for lifelong treatment, identifying key genetic biomarkers is essential to optimize patient safety, treatment adherence, and overall quality of life. This narrative review evaluates major gene-drug associations in HIV therapy, focusing on <i>HLA-B&#x2009;*&#x2009;57:01</i> for abacavir, <i>UGT1A1</i> for atazanavir and dolutegravir, and <i>CYP2B6</i> for efavirenz. The research includes an exhaustive review of pharmacogenomic databases (e.g. ClinPGx), regulatory agency labels (FDA, EMA, Swissmedic, HC-SC, PMDA), and clinical guidelines from CPIC and DPWG. Integrating pharmacogenetics into clinical practice significantly improves patient safety and treatment adherence. While <i>HLA-B&#x2009;*&#x2009;57:01</i> screening is widely implemented, barriers remain for other markers, including logistical challenges and the lack of genomic representation for African and Latin American populations. Clinicians must utilize evidence-based resources and remain updated on this evolving field to effectively tailor antiretroviral regimens and practice precision medicine. &#x2018;HIV Treatment: Why Your Genes Matter&#x2019;What is this article about? This article explains how pharmacogenetics &#x2013; <i>the study of how your DNA affects your response to medicine</i> &#x2013; is changing HIV care. Instead of a &#x201c;one-size-fits-all&#x201d; approach, physicians use genetic tests to choose the safest and most effective treatment for each person.Key Takeaways: Testing for the <i>HLA-B&#x2009;*&#x2009;57:01</i> gene prevents life-threatening reactions to abacavir.Genetic results help doctors prevent side effects like yellowing of the eyes from atazanavir or sleep problems and dizziness from efavirenz.Personalized doses based on your genes improve safety and help you to reach a better quality of life.The Future. While these tests are widely used, most research currently focuses on European populations. It is essential to expand this testing to include more people from African and Latin American backgrounds to ensure everyone benefits from precision medicine.