Consensus drug resistance mutations for epidemiological surveillance: basic principles and potential controversies.
Programmes that monitor local, national and regional levels of transmitted HIV-1 drug resistance inform treatment guidelines and provide feedback on the success of HIV-1 treatment and prevention programmes. The World Health Organization (WHO) has established a global programme for genotypic surveillance of HIV-1 drug resistance and has recommended the adoption of a consensus definition of genotypic drug resistance. Such a definition is necessary to accurately compare transmitted drug resistance rates across geographical regions and time periods. HIV-1 diversity and the large number of mutations associated with antiretroviral drug resistance complicate the development of a consensus definition for genotypic drug resistance. This paper reviews the data that must be considered to determine which of the many HIV-1 drug resistance mutations are likely to be both sensitive and specific indicators of transmitted drug resistance. The process used to create a previously published list of drug resistance mutations for HIV-1 surveillance is reviewed and alternative approaches to this process are discussed.
Shafer
Robert W
RW
Division of Infectious Diseases, Stanford University, Stanford, CA, USA. rshafer@stanford.edu
Rhee
Soo-Yon
SY
Bennett
Diane E
DE
D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D016000:Cluster Analysis; D004252:DNA Mutational Analysis; D030541:Databases, Genetic; D003906:Developing Countries; D024882:Drug Resistance, Viral / Q000235:genetics*; D015340:Epidemiologic Research Design; D005838:Genotype; D014943:Global Health; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D009154:Mutation; D009313:National Health Programs; D009862:Online Systems; D010802:Phylogeny; D011110:Polymorphism, Genetic; D011159:Population Surveillance; D016730:Program Development; D009626:Terminology as Topic; D016896:Treatment Outcome; D014944:World Health Organization
D044966:Anti-Retroviral Agents