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

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

Abstract

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 6 months. 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.

Notes

Acknowledgements

The work of F.H. was supported by grant 339‐065514 from Swiss National Science Foundation.

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • H. H. Hirsch
    • 1
    • 2
  • H. Drechsler
    • 1
  • A. Holbro
    • 1
    • 2
  • F. Hamy
    • 3
  • P. Sendi
    • 1
  • K. Petrovic
    • 3
  • T. Klimkait
    • 2
    • 3
  • M. Battegay
    • 1
  1. 1.Division of Infectious Diseases & Hospital Epidemiology, Department of Internal MedicineUniversity Hospital BaselBaselSwitzerland
  2. 2.Institute for Medical Microbiology, University of BaselBaselSwitzerland
  3. 3.Inpheno AG, BaselBaselSwitzerland

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