Replicative phenotyping adds value to genotypic resistance testing in heavily pre-treated HIV-infected individuals--the Swiss HIV Cohort Study

Fehr, Jan; Glass, Tracy R; Louvel, Séverine; Hamy, François; Hirsch, Hans H; von Wyl, Viktor; Böni, Jürg; Yerly, Sabine; Bürgisser, Philippe; Cavassini, Matthias; Fux, Christoph A; Hirschel, Bernard; Vernazza, Pietro; Martinetti, Gladys; Bernasconi, Enos; Günthard, Huldrych F; Battegay, Manuel; Bucher, Heiner C; Klimkait, Thomas and Swiss HIV Cohort Study, (2011). Replicative phenotyping adds value to genotypic resistance testing in heavily pre-treated HIV-infected individuals--the Swiss HIV Cohort Study. Journal of translational medicine, 9, p. 14. London: BioMed Central 10.1186/1479-5876-9-14

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Background

Replicative phenotypic HIV resistance testing (rPRT) uses recombinant infectious virus to measure viral replication in the presence of antiretroviral drugs. Due to its high sensitivity of detection of viral minorities and its dissecting power for complex viral resistance patterns and mixed virus populations rPRT might help to improve HIV resistance diagnostics, particularly for patients with multiple drug failures. The aim was to investigate whether the addition of rPRT to genotypic resistance testing (GRT) compared to GRT alone is beneficial for obtaining a virological response in heavily pre-treated HIV-infected patients.
Methods

Patients with resistance tests between 2002 and 2006 were followed within the Swiss HIV Cohort Study (SHCS). We assessed patients' virological success after their antiretroviral therapy was switched following resistance testing. Multilevel logistic regression models with SHCS centre as a random effect were used to investigate the association between the type of resistance test and virological response (HIV-1 RNA <50 copies/mL or ≥1.5log reduction).
Results

Of 1158 individuals with resistance tests 221 with GRT+rPRT and 937 with GRT were eligible for analysis. Overall virological response rates were 85.1% for GRT+rPRT and 81.4% for GRT. In the subgroup of patients with >2 previous failures, the odds ratio (OR) for virological response of GRT+rPRT compared to GRT was 1.45 (95% CI 1.00-2.09). Multivariate analyses indicate a significant improvement with GRT+rPRT compared to GRT alone (OR 1.68, 95% CI 1.31-2.15).
Conclusions

In heavily pre-treated patients rPRT-based resistance information adds benefit, contributing to a higher rate of treatment success.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Fux, Christoph Andreas

ISSN:

1479-5876

Publisher:

BioMed Central

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:24

Last Modified:

14 Dec 2014 19:31

Publisher DOI:

10.1186/1479-5876-9-14

PubMed ID:

21255386

Web of Science ID:

000286835700001

BORIS DOI:

10.7892/boris.8279

URI:

https://boris.unibe.ch/id/eprint/8279 (FactScience: 213796)

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