The role of baseline HIV-1 resistance testing in patients with established infection

被引：1
作者：
Chan S.-Y. [1 ]
Hulgan T. [1 ]
D'Aquila R.T. [1 ]
机构：
[1] Division of Infectious Diseases, Department of Medicine, Vanderbilt Univ. School of Medicine, Nashville, TN 37232
来源：
Current Infectious Disease Reports | 2004年 / 6卷 / 3期
基金：
美国国家卫生研究院;
关键词：
Human Leukocyte Antigen; Resistance Mutation; Resistance Testing; Reverse Tran; Established Infection;
D O I：
10.1007/s11908-004-0015-4
中图分类号：
学科分类号：
摘要：
Effective long-term treatment of HIV-I infection is challenging because of several factors, including antiretroviral drug resistance. Antiretroviral resistance testing has short-term benefit for optimizing the choice of a rescue regimen after treatment failure. Resistance testing also is recommended before therapy in pregnancy and acute infection or recent seroconversion. The benefit of routine resistance testing before starting treatment for established infection is less clear. This report summarizes the accumulating evidence of persistence of resistant mutants after initial infection, detectability of resistant virus with standard assays before treatment of established infection, the potential adverse impact of this baseline resistance on effectiveness of therapy, and the increasing prevalence of resistance in treatment-naïve patients. Taken together, these data suggest that pretreatment genotypic resistance testing also may be useful in patients with established infection. Although further study is needed, clinicians are now encouraged to routinely obtain pretreatment resistance testing. Copyright © 2004 by Current Science Inc.
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页码：243 / 249
页数：6
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  • [1] D'Aquila R.T., Johnson V.A., Welles S.L., Et al., Zidovudine resistance and HIV-1 disease progression during antiretroviral therapy, Ann. Intern. Med., 122, pp. 401-408, (1995)
  • [2] Lorenzi P., Opravil M., Hirschel B., Et al., Impact of drug resistance mutations on virologic response to salvage therapy. Swiss HIV Cohort Study, AIDS, 13, (1999)
  • [3] Zolopa A.R., Shafer R.W., Warford A., Et al., HIV-1 genotypic resistance patterns predict response to saquinavir-ritonavir therapy in patients in whom previous protease inhibitor therapy had failed, Ann. Intern. Med., 131, pp. 813-821, (1999)
  • [4] Rosenberg E.S., Altfeld M., Poon S.H., Et al., Immune control of HIV-1 after early treatment of acute infection, Nature, 407, pp. 523-526, (2000)
  • [5] Little S.J., Daar E.S., D'Aquila R.T., Et al., Reduced antiretroviral drug susceptibility among patients with primary HIV infection, JAMA, 282, pp. 1142-1149, (1999)
  • [6] Hirsch M.S., Brun-Vezinet F., D'Aquila R.T., Et al., Antiretroviral drug resistance testing in adult HIV-1 infection: Recommendations of an international AIDS Society-USA Panel, JAMA, 283, pp. 2417-2426, (2000)
  • [7] Durant J., Clevenbergh P., Halfon P., Et al., Drug-resistance genotyping in HIV-1 therapy: The VIRADAPT randomised controlled trial, Lancet, 353, pp. 2195-2199, (1999)
  • [8] Baxter J.D., Mayers D.L., Wentworth D.N., Et al., A randomized study of antiretroviral management based on plasma genotypic antiretroviral resistance testing in patients failing therapy, AIDS, 14, (2000)
  • [9] Tural C., Ruiz L., Holtzer C., Et al., Clinical utility of HIV-1 genotyping and expert advice: The Havana trial, AIDS, 16, pp. 209-218, (2002)
  • [10] Cingolani A., Antinori A., Rizzo M.G., Et al., Usefulness of monitoring HIV drug resistance and adherence in individuals failing highly active antiretroviral therapy: A randomized study (ARGENTA), AIDS, 16, pp. 369-379, (2002)
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