AEGiS-14IAC: GART Rounds: a model for group interpretation of genotypic resistance test results.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

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GART Rounds: a model for group interpretation of genotypic resistance test results.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10178)

MacVeigh MS, Parrish DA
Multnomah County Health Dept, Portland, OR, United States

BACKGROUND: Interpretation of GART assay results is believed affected by experience, expertise and opinions of the care provider. To help gain experience and share opinions, a system of group reviews of GART results was established at our county HIV clinic, where 600 patients are managed by 4 providers. The initial goals were to improve skill levels, and to track the effect of both the GART results, and the group consensus, on choice of regimens.

METHODS: Beginning in July 2001, GART ordering was accompanied by completion of a form identifying the current regimen, planned new regimen, labs, and demographics. The provider's post-GART choice of regimen was added. Finally, after presentation at GART rounds attended by the providers and clinical pharmacist, the group consensus opinion was recorded.

RESULTS: A total of 36 cases were reviewed. Changes in treatment plans after GART results occurred in 15 cases (44%). After "GART Rounds", 22 cases (61%) had changes from the provider's post-GART plan. Group consensus regimens changed initial post-GART treatment plans in 64%, 64%, 60%, & 67% for 1st through 4th HAART failure, respectively. The average number of treatment failures was 2. The mean time from testing to group presentation (days) was shortened by the number of treatment failures [1st -4th]: 56, 46, 37, 32. Mean time to treatment failure (days) showed the following [1st- 4th]: 540, 379, 182, 366. Average time to failure was 178d in patients never achieving VL <400, compared to 551d if ever <400.

CONCLUSIONS: The use of a group process for interpretation of GART results substantially impacts the choice of regimens. Certain trends are emerging, including the influence of treatment failures on providers' pursuit of group input (in time). The more treatment experienced patients displayed more rapid virologic failure. Future tracking will include the ability to assess whether patients were placed on the chosen regimens, and subsequent virologic and CD4 responses.

Keywords: AEGIS, HIV Infections, HIV, Antiretroviral Therapy, Highly Active, Anti-HIV Agents, HIV Protease Inhibitors, Treatment Failure, HIV-1 Reverse Transcriptase, Research Design, Demography, HumanKWDaegis,hivinfections,hiv,antiretroviraltherapy,highlyactive,anti-hivagents,hivproteaseinhibitors,treatmentfailure,hiv-1reversetranscriptase,researchdesign,demography,human

020707
B10178

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.