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HIV resistance testing: methods, utility, and limitations
1Center for Molecular Biology and Pathology, Laboratory Corporation of America, Research Triangle Park, NC 27709, USA. alcornt@labcorp.com
Molecular Diagnosis : a Journal Devoted to the Understanding of Human Disease Through the Clinical Application of Molecular Biology
|November 9, 2000
Summary
Antiretroviral resistance testing is crucial for optimizing HIV treatment due to rising drug resistance. Both genotypic and phenotypic assays aid in guiding therapy, improving patient outcomes and becoming standard care.
Area of Science:
- Virology
- Infectious Diseases
- Pharmacology
Background:
- Combination antiretroviral therapy (cART) for HIV has increased the incidence of drug resistance.
- Antiretroviral resistance testing is essential for selecting effective therapeutic strategies.
- Genotypic and phenotypic assays are the primary methods for HIV resistance analysis.
Purpose of the Study:
- To review the role and methodologies of antiretroviral resistance testing in HIV management.
- To compare genotypic and phenotypic resistance assays and their clinical utility.
- To highlight the growing importance of resistance testing in the standard of care for HIV treatment.
Main Methods:
- Genotypic assays detect resistance-associated mutations in the HIV genome.
- Phenotypic assays directly measure viral susceptibility to antiretroviral drugs.
- Comparison of assay speed, technical demands, interpretability, and clinical correlation.
Main Results:
- Genotypic assays are faster and less complex but can be difficult to interpret.
- Phenotypic assays offer easier interpretation but have limited data correlating resistance levels to clinical response.
- Both methods contribute to optimizing therapeutic choices.
Conclusions:
- HIV resistance testing, despite assay limitations, improves therapeutic outcomes.
- Resistance testing is increasingly integrated into the standard of care for HIV treatment.
- Continued development and validation of resistance assays are vital for effective HIV management.