The need for more sophisticated analyses

As the divergent results of interpretations studies show, use of resistance testing to select treatment requires refinement. In order to select new regimens more accurately, clinical studies will need to define the following for each drug that is available:

  • A genotype and phenotype correlation from clinical isolates, in order to establish the degree of susceptibility to new agents.
  • A correlation of genotype and virological outcome, in order to establish the degree of response that can be expected.

Clinicians might also want to know about the correlation between genotypic resistance and treatment history.

The first type of analysis will need to be carried out with large databases, and has already been addressed to some extent by Virco's Virtual Phenotype database. This has also been validated by using the virtual phenotype to predict response in clinical trials.

The second type of analysis, which is critically dependent on establishing a genotype/phenotype relationship, also requires a large database. Some companies, such as Abbott, have carried out analyses to correlate genotypic and phenotypic resistance with virologic response, but this is not an evolving database and cannot accommodate such factors as non-B subtypes or the impact of new mutational patterns contributed by new drugs.

As interpretation becomes more complex, it raises the prospect that information regarding resistance will become a proprietary product, and that clinics which can pay for access to interpretation systems will have better outcomes than clinics where budgets are restricted.

Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.