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Genotypic and phenotypic resistance testing of HIV-1 in routine clinical care

Hirsch, H. ; Drechsler, H. ; Holbro, A. ; Hamy, F. ; Sendi, P. ; Petrovic, K. ; Klimkait, T. ; Battegay, M.

In: European Journal of Clinical Microbiology and Infectious Diseases, 2005, vol. 24, no. 11, p. 733-738

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    Titre
    • Genotypic and phenotypic resistance testing of HIV-1 in routine clinical care
    Auteur
    • Hirsch, H.. Division of Infectious Diseases & Hospital Epidemiology, Department of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
    • Drechsler, H.. Division of Infectious Diseases & Hospital Epidemiology, Department of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
    • Holbro, A.. Division of Infectious Diseases & Hospital Epidemiology, Department of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
    • Hamy, F.. Inpheno AG, Basel, Vesalgasse 1, 4051, Basel, Switzerland
    • Sendi, P.. Division of Infectious Diseases & Hospital Epidemiology, Department of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
    • Petrovic, K.. Inpheno AG, Basel, Vesalgasse 1, 4051, Basel, Switzerland
    • Klimkait, T.. Institute for Medical Microbiology, University of Basel, Petersplatz 10, 4003, Basel, Switzerland
    • Battegay, M.. Division of Infectious Diseases & Hospital Epidemiology, Department of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Clinical Microbiology and Infectious Diseases, 2005, vol. 24, no. 11, p. 733-738. Springer-Verlag
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:310286
    Summary
    Data on genotypic and phenotypic resistance testing of HIV-1 in the routine clinical setting are lacking. In a retrospective single-center study, all patients (n=102) for whom genotypic resistance typing (GRT) and phenotypic resistance typing (PRT) were performed during the calendar year 2002 were examined. GRT and PRT results were concordant for 79% of the drugs, being highest for nevirapine (92%) and lowest for didanosine (57%). Concordance of results for protease inhibitors was lowest for lopinavir (78%) and highest for indinavir (88%). Discordant results for lamivudine were observed in 16% of patients; 90% of these results corresponded to high-level resistance by PRT and susceptibility by GRT. Overall, HIV loads were lower and CD4+ cell counts higher after therapy following resistance testing, but a significant association with the number of active drugs as predicted by GRT or PRT could not be identified. In a subgroup of 43 patients with virological failure under antiretroviral therapy and sufficient follow-up data, HIV loads were significantly lower after 3 and 6months. More patients with HIV loads <400/ml had 2 or more active drugs according to PRT (21/29 [75%]) than according to GRT ([15/29 [52%]; p=0.109. This was also found for HIV loads <50/ml (PRT 16/22 [72%], GRT 10/22 [42%]; p=0.103), although the differences were not statistically significant. There was no discernable difference between GRT and PRT in the clinic-based population, but the numbers of resistance tests performed are not sufficient to draw definitive conclusions