Lege Artis Medicinae

[NEW PROSPECTS IN MEDICINE BY THE APPLICATION OF BIOTECHNOLOGICAL METHODS]

KOSZTOLÁNYI György

OCTOBER 20, 2005

Lege Artis Medicinae - 2005;15(10)

[The recent completion of the sequence of the human genome - thanks to the developments in biotechnology - has increased interest in genetics, but confusion remains about the role of genetic information in the medical practice. The role of genomics (a term coined only 15 years ago) in medicine is even more confusing. This review summarizes briefly the most important advances relating to the robust development in biotechnology, by which the practice of medicine has entered an era where the individual patient’s genome could help to determine the optimal approach to care, whether it is preventive, diagnostic, or therapeutic.]

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[Authors discuss data published in the last 2-3 years indicating that besides the characteristics of the virus itself, the natural course of HIV disease is also regulated by genetic factors from the very onset till the end. Susceptibility for HIV infection of the carriers of a non-expressing mutant allele (CCR5Δ32) of one of the main coreceptors of HIV is markedly lower than that of the non-carriers. HLA-concordancy, that is few differences in the HLA alleles between the infected and noninfected partners, increases the chance of the HIVtransmittal. On the other hand, carriage of some HLA genotype e.g. that of the HLA A2/6802 supertype may significantly decrease the risk of the sexually transmitted HIV infection or that of the HIV infection from the mother to child. The rate of progression of the HIV disease which may vary in broad range from the median value of 10 years is also dependent on genetic factors. Progression is lower than the average in the carriers of the CCR5Δ32, HLA-B*27 and HLAB* 57 alleles while it is significantly more rapid in carriers of the HLA-B*35.1 allele. Recent data on the regulation by genetic factors of some sideeffects and the efficacy of combined antiretroviral treatment indicate that in the near future individual treatment may be used on the basis of the genetic background of the patients.]

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