Journal Article

Long-Term Efficacy of Routine Access to Antiretroviral-Resistance Testing in HIV Type 1–Infected Patients: Results of the Clinical Efficacy of Resistance Testing Trial

Scott A. Wegner, Mark R. Wallace, Naomi E. Aronson, Sybil A. Tasker, David L. Blazes, Cindy Tamminga, Susan Fraser, Matthew J. Dolan, Kevin T. Stephan, Nelson L. Michael, Linda L. Jagodzinski, Maryanne T. Vahey, Joyce L. Gilcrest, LaRee Tracy, Mark J. Milazzo, Daniel J. Murphy, Paula McKenna, Kurt Hertogs, Alex Rinehart, Brendan Larder and Deborah L. Birx

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 5, pages 723-730
Published in print March 2004 | ISSN: 1058-4838
Published online March 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/381266
Long-Term Efficacy of Routine Access to Antiretroviral-Resistance Testing in HIV Type 1–Infected Patients: Results of the Clinical Efficacy of Resistance Testing Trial

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  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

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The long-term efficacy of making resistance testing routinely available to clinicians has not been established. We conducted a clinical trial at 6 US military hospitals in which volunteers infected with human immunodeficiency virus type–1 were randomized to have routine access to phenotype resistance testing (PT arm), access to genotype resistance testing (GT arm), or no access to either test (VB arm). The primary outcome measure was time to persistent treatment failure despite change(s) in antiretroviral therapy (ART) regimen. Overall, routine access to resistance testing did not significantly increase the time to end point. Time to end point was significantly prolonged in the PT arm for subjects with a history of treatment with ⩾4 different ART regimens or a history of treatment with nonnucleoside reverse-transcriptase inhibitors before the study, compared with that in the VB arm. These results suggest that routine access to resistance testing can improve long-term virologic outcomes in HIV-infected patients who are treatment experienced but may not impact outcome in patients who are naive to or have had limited experience with ART.

Journal Article.  4414 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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