Variable prediction of antiretroviral treatment outcome by different systems for interpreting genotypic human immunodeficiency vires type 1 drug resistance

Andrea De Luca, Antonella Cingolani, Simona Di Giambenedetto, Maria Paola Trotta, Francesco Baldini, Maria Gabriella Rizzo, Ada Bertoli, Giuseppina Liuzzi, Pasquale Narciso, Rita Murri, Adriana Ammassari, Carlo Federico Perno, Andrea Antinori

Research output: Contribution to journalArticle

Abstract

To determine the variability of genotypic human immunodeficiency virus (HIV) type 1 drug-resistance interpretation by available expert systems and its clinical implications, 261 subjects for whom a potent antiretroviral regimen was failing who were starting salvage therapy were evaluated. The association of the genotypic susceptibility score (GSS) of the salvage regimen, according to 11 interpretation systems, with HIV RNA outcomes for 6 months was examined. GSS was highly variable, as determined by the different interpretation systems, and showed independent correlation with changes from baseline HIV RNA levels at 6 months with 5 systems - Stanford hivdb, GuideLines 3.0, Retrogram 1.4, HIVresistanceWeb, and São Paulo University. Most GSSs predicted virologic response in regimens containing stavudine, lamivudine, efavirenz, or indinavir. Selected systems predicted response in regimens containing didanosine, abacavir, or nelfinavir, and no system predicted outcome of boosted protease inhibitors. GSSs predicted changes in HIV RNA levels better in adherent patients than in nonadherent individuals. Interpretation may be improved, and knowledge should be used uniformly throughout different expert systems.

Original languageEnglish
Pages (from-to)1934-1943
Number of pages10
JournalJournal of Infectious Diseases
Volume187
Issue number12
DOIs
Publication statusPublished - Jun 15 2003

ASJC Scopus subject areas

  • Immunology
  • Public Health, Environmental and Occupational Health

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