Figure 2. Selection of Resistant HIV

This diagram shows the concept of selective pressure by antiretroviral therapy. Predominant wild-type HIV dominates prior to antiretroviral therapy. Under the selective pressure of antiretroviral therapy, the resistant HIV has an advantage over wild-type strains and thus resistant HIV will increase in the setting of inadequate HIV suppression. Further selective pressure generated by antiretroviral medications in the setting of inadequate viral suppression leads to the development of predominant resistant HIV.

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