Viral resistance is an important reason why antiretroviral therapy fails. Laboratory
methods for determining resistance of HIV-1 to antiretroviral drugs have been available
since 1989 [
[1]
]. Neither of the two main approaches—genotyping and phenotyping—is clearly superior
for monitoring clinical progression. Because resistance testing is costly, it should
be reserved for select situations. The indications for ordering it will evolve as
new information from patients receiving combination antiretroviral therapy emerges.
At present, HIV-1 resistance testing is recommended for patients whose antiretroviral
regimens are changed because of failure of their present regimen and for pregnant
women who have detectable plasma viremia, to optimize their own treatment and to prevent
transmission of HIV-1 to their infants [
[2]
]. Resistance testing should be considered before the initiation of therapy for acute
or recently established infection or in some locales with a particularly high prevalence
of resistance to particular drugs [
[2]
].To read this article in full you will need to make a payment
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Article info
Footnotes
☆This work was supported in part by grants from the National Institutes of Health (AI27661), the Minnesota Medical Foundation, and the International Center for Antiviral Research and Epidemiology.
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Copyright
© 2003 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
