AEGiS-14IAC: Clinical impact of HIV genotypic resistance testing: comparison between two methods.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

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Clinical impact of HIV genotypic resistance testing: comparison between two methods.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10183)

Setti M, Bruzzone B, Murdaca G, Gota F, Marasso P, Bacilieri S, Icardi G
University of Genoa, Genoa, Italy

OBJECTIVE: to assess the difference of impact on clinical outcome between two methods of testing genotypic drug resistance in a cohort of HIV+ subjects undergoing HAART.

METHODS: 32 HIV+ naïve (12) or treatment-failed (20) compliant individuals sequenced (TruGene-Visible Genetics) before starting a three-drug protocol were selected. Response to treatment was assessed at six months as CR (both CD4+ count > than +25% and viral load undetectable or < than -1Log with respect to basal), PR or NR (one or none of the above). In the same samples, key mutations were retrospectively searched (LiPA-RT/PI-Innogenetics) and the results compared. The same clinician was then asked to indicate the protocol he would have chosen for each patient if he had had these results in spite of those from sequencing. Different protocols were plotted against response.

RESULTS: both methods detected 12 WT virus (all naïve subjects) and several resistance related mutations in the 20 pretreated subjects, all in combination of two or more, but one single with LiPA. The clinical outcome was CR in 18 individuals PR in 6 and NR in 8. The choice of treatment would have been the same in all the subjects but 8, in which a "genotypically" ineffective NNRTI would have been given in spite of a drug actually used. However, 3 of these "multiresistant" patients turned out to belong to the NR group, and failed anyway. Interestingly, though LiPA method lacks news on NNRTI, the majority of protocols including those drugs were not different in the two choices.

CONCLUSION: the pattern of antiretroviral drug resistance as assessed by the the two methods resulted remarkably similar as far as the same codons were tested, and expectedly different otherwise. However, very few differences were found in the formulation of the protocols and even fewer in the ultimate clinical outcome. Although coming from a limited number of cases, our data show that the clinical impact of the two methods appears to be superimposable.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, Viral Load, HIV Infections, HIV-1 Reverse Transcriptase, Anti-HIV Agents, HIV Protease, CD4 Lymphocyte Count, HIV, HIV Protease Inhibitors, Mutation, Codon, Human, methods, geneticsKWDaegis,antiretroviraltherapy,highlyactive,viralload,hivinfections,hiv-1reversetranscriptase,anti-hivagents,hivprotease,cd4lymphocytecount,hiv,hivproteaseinhibitors,mutation,codon,human,methods,genetics

020707
B10183

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