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Resistance tests: what do clinical trials tell us?
Journal of HIV Therapy
|May 8, 2003
Summary
Randomized trials show that HIV drug resistance testing offers clinical benefits. Further research should focus on optimizing the cost-effective use of these expensive tests.
Area of Science:
- Virology
- Clinical Medicine
- Health Economics
Background:
- Few routine laboratory tests undergo rigorous evaluation via randomized controlled trials (RCTs).
- HIV drug resistance assays, both genotypic and phenotypic, have been subjects of such RCTs.
Purpose of the Study:
- To evaluate the clinical utility and benefit of HIV drug resistance testing for clinicians.
- To analyze the variability in results across existing studies and identify contributing factors.
Main Methods:
- Studies employed a randomized design, comparing patients receiving resistance tests versus standard care during acute viral failure.
- Primary endpoints focused on the proportion of patients achieving undetectable viral load at 12-24 weeks post-randomization.
Main Results:
- Most studies demonstrated a clinical benefit associated with the use of HIV drug resistance testing.
- Significant variation exists in the outcomes of these studies, with potential influencing factors identified.
Conclusions:
- While HIV drug resistance testing shows clinical benefit, the window for conducting further large-scale RCTs may be closing.
- Future efforts should prioritize identifying factors for the most cost-effective application of these valuable diagnostic tools.
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