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HIV-1 Infection | Antiretroviral Drug Resistance Testing Recommendations

Purpose: To determine if a patient with HIV-1 infection should have her or his virus tested for antiretroviral drug resistance.

Description

The presence of antiretroviral drug resistance in HIV-1 isolates correlates with poor virologic response to therapy with the implicated agents. A panel of experts in the care of AIDS patients has issued recommendations for when clinicians should order resistance testing in their patients.


 

Conditions where resistance testing should be considered (therapy should not be delayed while waiting for test results):

(1) primary HIV infection: to detect infection with a drug-resistant strain

(2) established HIV infection (patient presenting HIV antibody positive, previously untreated): to detect infection with a drug-resistant species; however, false negative results may occur if drug-resistant quasispecies have reverted to wild type strains

 

Conditions where resistance testing is recommended:

(1) after first regimen failure: if more than one agent is being administered, can document agent(s) which need to be changed

(2) after multiple regimen failures: allows exclusion of drugs to which response is unlikely

(3) during pregnancy: to optimize maternal treatment and prophylactic therapy for the neonate.

 


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Specialty

Objective

ICD-10