Use of genotypic HIV DNA testing: a DELPHI-type consensus

Area of Science:

• Virology
• Infectious Diseases
• Molecular Diagnostics

Background:

• Significant disparities exist in the clinical application of human immunodeficiency virus (HIV) DNA sequencing.
• A need for standardized practices in HIV DNA sequencing techniques and result interpretation was identified in France.

Purpose of the Study:

• To establish a DELPHI-type consensus for homogenizing the use, techniques, and interpretation of HIV DNA sequencing in France.
• To provide evidence-based recommendations for clinical decision-making regarding HIV DNA genotyping.

Main Methods:

• A steering committee formulated 20 statements based on literature review and clinical expertise.
• Statements were anonymously voted on by 21 virologists and 47 HIV clinicians in France.
• Voting occurred in two rounds between October and December 2022.

Main Results:

• A strong consensus (90%) was reached on 18 out of 20 statements.
• Key agreements include the utility of HIV DNA genotyping for guiding switches to long-acting regimens and simplifying antiretroviral therapy in specific scenarios.
• No consensus was achieved on reporting viral minority populations and the virological failure risk with certain antiretroviral combinations in specific patient groups.

Conclusions:

• The DELPHI-type consensus provides a framework for strengthening and harmonizing best practices in HIV DNA sequencing.
• Standardized approaches will enhance the reliable clinical utility of HIV DNA genotyping.