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
Open Access
- 1 March 2004
- journal article
- clinical trial
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 38 (5), 723-730
- https://doi.org/10.1086/381266
Abstract
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.Keywords
This publication has 22 references indexed in Scilit:
- Antiretroviral-Drug Resistance among Patients Recently Infected with HIVNew England Journal of Medicine, 2002
- Economic Evaluation of Drug Resistance Genotyping for the Adaptation of Treatment in HIV-Infected Patients in the VIRADAPT StudyJAIDS Journal of Acquired Immune Deficiency Syndromes, 2000
- Antiretroviral Drug Resistance Testing in Adult HIV-1 InfectionJAMA, 2000
- Drug-resistance genotyping in HIV-1 therapy: the VIRAD APT randomi sed controlled trialThe Lancet, 1999
- Impact of drug resistance mutations on virologic response to salvage therapyAIDS, 1999
- Activities of cefepime and five other antibiotics against nosocomial PER-1-type and/or OXA-10-type beta-lactamase-producing Pseudomonas aeruginosa and Acinetobacter spp.Journal of Antimicrobial Chemotherapy, 1998
- Antiretroviral Drug Resistance Testing in Adults With HIV InfectionJAMA, 1998
- Prevalence and Clinical Significance of Zidovudine Resistance Mutations in Human Immunodeficiency Virus Isolated from Patients after Long-Term Zidovudine TreatmentThe Journal of Infectious Diseases, 1995
- Zidovudine Resistance and HIV-1 Disease Progression during Antiretroviral TherapyAnnals of Internal Medicine, 1995
- A sharper Bonferroni procedure for multiple tests of significanceBiometrika, 1988