- What is resistance?
- Resistance to nucleoside reverse transcriptase inhibitors
- Resistance to non-nucleoside reverse transcriptase inhibitors
- Resistance to protease inhibitors
- Resistance to fusion inhibitors
- Resistance to integrase inhibitors
- Limiting the chance of resistance
- Transmission of resistant HIV
- Resistance in non-B HIV subtypes
- Resistance testing
- Guiding treatment with resistance testing
- Guidelines
- Genotype vs. phenotype vs. treatment history: the CERT and NARVAL studies
- Genotype vs. treatment history: VIRADAPT, GART and ARGENTA
- Phenotype vs. treatment history
- The need for expert interpretation
- Comparing interpretation systems
- Virtual phenotype vs phenotype
- The need for more sophisticated analyses
- Phenotypic or genotypic susceptibility score
- Detecting rare but significant mutations
- Selecting drugs: using therapeutic drug monitoring with resistance testing
- Identifying resistance to a single drug
Guiding treatment with resistance testing
Despite the evidence that resistance testing can predict treatment response, many doctors are cautious about its use in the clinical setting. Most see it as a potential adjunct to existing ways of determining drug regimens and decisions about switching therapy. This caution has been shaped by early results of clinical trials of resistance testing which showed, at best, only moderate benefit in the short term. These factors, combined with the limited availability of resistance assays in the United Kingdom, have meant these tests were not widely used in the past.
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