TY - JOUR
T1 - Variable prediction of antiretroviral treatment outcome by different systems for interpreting genotypic human immunodeficiency vires type 1 drug resistance
AU - De Luca, Andrea
AU - Cingolani, Antonella
AU - Di Giambenedetto, Simona
AU - Trotta, Maria Paola
AU - Baldini, Francesco
AU - Rizzo, Maria Gabriella
AU - Bertoli, Ada
AU - Liuzzi, Giuseppina
AU - Narciso, Pasquale
AU - Murri, Rita
AU - Ammassari, Adriana
AU - Perno, Carlo Federico
AU - Antinori, Andrea
PY - 2003/6/15
Y1 - 2003/6/15
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=0038238324&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0038238324&partnerID=8YFLogxK
U2 - 10.1086/375355
DO - 10.1086/375355
M3 - Article
C2 - 12792870
AN - SCOPUS:0038238324
VL - 187
SP - 1934
EP - 1943
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
SN - 0022-1899
IS - 12
ER -