Antiretroviral drug resistance testing in adult HIV-1 infection: 2008 recommendations of an International AIDS Society-USA panel.
Resistance to antiretroviral drugs remains an important limitation to successful human immunodeficiency virus type 1 (HIV-1) therapy. Resistance testing can improve treatment outcomes for infected individuals. The availability of new drugs from various classes, standardization of resistance assays, and the development of viral tropism tests necessitate new guidelines for resistance testing. The International AIDS Society-USA convened a panel of physicians and scientists with expertise in drug-resistant HIV-1, drug management, and patient care to review recently published data and presentations at scientific conferences and to provide updated recommendations. Whenever possible, resistance testing is recommended at the time of HIV infection diagnosis as part of the initial comprehensive patient assessment, as well as in all cases of virologic failure. Tropism testing is recommended whenever the use of chemokine receptor 5 antagonists is contemplated. As the roll out of antiretroviral therapy continues in developing countries, drug resistance monitoring for both subtype B and non-subtype B strains of HIV will become increasingly important.
Hirsch
Martin S
MS
Harvard Medical School, Boston, Massachusetts, USA. mshirsch@partners.org
Günthard
Huldrych F
HF
Schapiro
Jonathan M
JM
Brun-Vézinet
Françoise
F
Clotet
Bonaventura
B
Hammer
Scott M
SM
Johnson
Victoria A
VA
Kuritzkes
Daniel R
DR
Mellors
John W
JW
Pillay
Deenan
D
Yeni
Patrick G
PG
Jacobsen
Donna M
DM
Richman
Douglas D
DD
D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D065100:CCR5 Receptor Antagonists; D024882:Drug Resistance, Viral / Q000502:physiology; D005260:Female; D023581:HIV Fusion Inhibitors / Q000494:pharmacology; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics / Q000502:physiology; D054298:Human Immunodeficiency Virus Proteins / Q000187:drug effects / Q000235:genetics; D006801:Humans; D019429:Integrase Inhibitors / Q000494:pharmacology; D008826:Microbial Sensitivity Tests / Q000379:methods*; D009154:Mutation; D011247:Pregnancy; D011480:Protease Inhibitors / Q000494:pharmacology; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology; D017211:Treatment Failure; D018523:Tropism
D019380:Anti-HIV Agents; D065100:CCR5 Receptor Antagonists; D023581:HIV Fusion Inhibitors; D054298:Human Immunodeficiency Virus Proteins; D019429:Integrase Inhibitors; D011480:Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors