Journal Article

Accuracy, Precision, and Consistency of Expert HIV Type 1 Genotype Interpretation: An International Comparison (The GUESS Study)

Andrew R. Zolopa, Laura C. Lazzeroni, Alex Rinehart, Françoise Brun Vezinet, François Clavel, Ann Collier, Brian Conway, Roy M. Gulick, Mark Holodniy, Carlo-Frederico Perno, Robert W. Shafer, Douglas D. Richman, Mark A. Wainberg and Daniel R. Kuritzkes

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 41, issue 1, pages 92-99
Published in print July 2005 | ISSN: 1058-4838
Published online July 2005 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/430706
Accuracy, Precision, and Consistency of Expert HIV Type 1 Genotype Interpretation: An International Comparison (The GUESS Study)

More Like This

Show all results sharing these subjects:

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

GO

Show Summary Details

Preview

Background. Resistance testing is considered standard of care in HIV medicine, but there is no standard interpretation system for genotype tests. We sought to determine how much agreement exists within a group of experts in the interpretation of complex genotypes.

Methods. Genotypes from clinical specimens were sent to an international panel of 12 resistance experts. Phenotypic susceptibility testing of these clinical isolates was performed with antivirogram. Experts predicted phenotype fold change category (<2.5-fold change, 2.5–4.0-fold change, >4.0- to 7.0-fold change, >7.0- to 10-fold change, >10- to 20-fold change, or >20-fold change) and predicted expected drug activity for each of 16 antiretroviral drugs. Experts were also asked to make treatment recommendations on the basis of the genotype.

Results. The experts predicted the exact phenotype fold change category correctly 44% of the time, but they varied widely by antiretroviral drug (range, 25%–74%). The highest accuracy was observed for lamivudine (74%) and the nonnucleoside reverse transcriptase inhibitors (66%–69%). Experts generally predicted higher levels of resistance to the remaining nucleoside reverse transcriptase inhibitors than what was found by phenotypic testing. Agreement among experts in predicting phenotype fold change category ranged widely depending on the drug (median agreement, 42% [range, 28%–74%]); the same pattern was observed in predicting expected drug activity (median agreement, 45% [range, 32%–87%]). Experts agreed on treatment recommendations in a median of 79% of instances, and recommendations were consistent over time, with blinded retesting.

Conclusions. Although their ability to predict phenotype from a genotype varied for individual antiretroviral drugs, this expert panel had a high degree of agreement in deriving treatment recommendations from the genotype.

Journal Article.  4293 words.  Illustrated.

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

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.