Related Experiment Video
Updated: Jun 23, 2026

Implementation of In Vitro Drug Resistance Assays: Maximizing the Potential for Uncovering Clinically Relevant Resistance Mechanisms
Published on: December 9, 2015
Clinical approach to drug resistance interpretation: expert advice
Bonaventura Clotet1, Roger Paredes
1HIV Unit and Retrovirology Laboratory 'Irsicaixa' Foundation, Hospital Universitari Germans Trias i Pujol, UAB, Badalona, Catalonia, Spain. bclotet@irsicaixa.es
Purpose Of Review:
The body of knowledge regarding antiretroviral drug resistance is rapidly evolving as a result of extensive research and the continuous availability of new antiretroviral drugs. The interpretation of drug resistance tests may be difficult for clinicians not working in highly specialized healthcare environments. This may lead to inadequate treatment decisions, and can compromise the efficacy of antiretroviral regimens.
Recent Findings:
Several studies have demonstrated better virological outcomes if the design of second and subsequent antiretroviral treatment lines incorporates expert advice in addition to genotypic resistance testing. The benefits of expert advice are limited to therapies to treat the second antiretroviral failure and probably extend to four or five failures. It confers no additional benefit if multiple and equally effective treatment options are available (i.e. after the first antiretroviral treatment failure) or if treatment alternatives are severely limited (i.e. after multiple treatment lines have failed). Conference calls provide a means of improving the availability of healthcare providers.
Summary:
Expert advice helps to optimize the design of salvage therapy after the second to the fourth or fifth treatment failure. It provides a continuous update to clinicians and can be made easily and broadly available through conference calls.
Related Concept Videos
Treatment Resistant Cancers
Factors Affecting Drug Response: Overview
Drug toxicity: Idiosyncratic Reactions
Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu
Drug Toxicity: Risk factors
Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase
