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Titolo:
Clinical utility of resistance testing: Retrospective and prospective datasupporting use and current recommendations
Autore:
Haubrich, R; Demeter, L;
Indirizzi:
Univ Calif San Diego, Div Infect Dis, San Diego, CA 92103 USA Univ Calif San Diego San Diego CA USA 92103 Dis, San Diego, CA 92103 USA Univ Rochester, Med Ctr, Div Infect Dis, New York, NY USA Univ Rochester New York NY USA Med Ctr, Div Infect Dis, New York, NY USA
Titolo Testata:
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
, volume: 26, anno: 2001, supplemento:, 1
pagine: S51 - S59
SICI:
1525-4135(20010301)26:<S51:CUORTR>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROTEASE INHIBITOR THERAPY; HIV DRUG-RESISTANCE; SUSCEPTIBILITY; TRANSMISSION; INFECTION; REGIMENS;
Keywords:
phenotype; genotype; resistance; virologic response; predictors of response;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Haubrich, R Univ Calif San Diego, Div Infect Dis, 150 W Washington St,Suite 100, San Diego, CA 92103 USA Univ Calif San Diego 150 W Washington St,Suite 100 San Diego CA USA 92103
Citazione:
R. Haubrich e L. Demeter, "Clinical utility of resistance testing: Retrospective and prospective datasupporting use and current recommendations", J ACQ IMM D, 26, 2001, pp. S51-S59

Abstract

Data from retrospective and prospective studies support use of genotypic and phenotypic resistance assays to guide treatment changes when initial or subsequent antiretroviral regimens fail. Several retrospective studies haveshown that response to antiretroviral therapy can be predicted based on genotypic analysis of HIV, with baseline genotypic evidence of resistance predicting virologic failure. Other retrospective analyses demonstrated that phenotypic drug sensitivity correlates with increased viral load suppression, particularly when virus remains sensitive to two or three drugs at initiation of the regimen. Furthermore, prospective studies such as VIRADAPT and Genotype-Assisted Antiretroviral Resistance Testing (GART) have substantiated that drug selection based on genotypic assay results yield superior viral suppression compared with empiric treatment assignment. One additional study suggested significant improvement in short-term virologic outcome when phenotypic testing was used to guide treatment selection. Based on these findings, resistance testing is currently recommended for patients with acuteHIV infection, those who have failed one or more antiretroviral regimens, and pregnant women. Although these tests move toward becoming a standard ofcare, several research questions remain: the long-term benefit of resistance testing is not yet certain, the interpretation of specific genotypic resistance patterns needs to be better defined, and clinical cut-off points for phenotypic resistance need to be established. As these issues continue tobe studied, resistance testing likely will prove a reliable tool to help plan successful ART strategies.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 17:53:16