Replicative phenotyping adds value to genotypic resistance testing in heavily pre-treated HIV-infected individuals - the Swiss HIV Cohort Study - Publication

Publication

Replicative phenotyping adds value to genotypic resistance testing in heavily pre-treated HIV-infected individuals - the Swiss HIV Cohort Study

Journal Paper/Review - Jan 21, 2011

Fehr Jan, Hirschel Bernard, Vernazza Pietro, Martinetti Gladys, Bernasconi Enos, Günthard Huldrych F, Battegay Manuel, Bucher Heiner C, Klimkait Thomas, Fux Christoph A, Cavassini Matthias, Glass Tracy R, Louvel Severine, Hamy Francois, Hirsch Hans H, von Wyl Viktor, Böni Jürg, Yerly Sabine, Bürgisser Philippe, Hiv Cohort Study And The Swiss

Citation

Fehr J, Hirschel B, Vernazza P, Martinetti G, Bernasconi E, Günthard H, Battegay M, Bucher H, Klimkait T, Fux C, Cavassini M, Glass T, Louvel S, Hamy F, Hirsch H, von Wyl V, Böni J, Yerly S, Bürgisser P, Hiv Cohort Study A. Replicative phenotyping adds value to genotypic resistance testing in heavily pre-treated HIV-infected individuals - the Swiss HIV Cohort Study. J Transl Med 2011; 9:14.

Type

Journal Paper/Review (English)

Journal

J Transl Med 2011; 9

Publication Date

Jan 21, 2011

Issn Electronic

1479-5876

Brief description/objective

ABSTRACT: BACKGROUND: Replicative phenotypic HIV resistance testing (rPRT) uses recombinant infectious virus to measure viral replication in the presence of antiretroviral drugs. Due to its high sensitivity of detection of viral minorities and its dissecting power for complex viral resistance patterns and mixed virus populations rPRT might help to improve HIV resistance diagnostics, particularly for patients with multiple drug failures. The aim was to investigate whether the addition of rPRT to genotypic resistance testing (GRT) compared to GRT alone is beneficial for obtaining a virological response in heavily pre-treated HIV-infected patients. METHODS: Patients with resistance tests between 2002 and 2006 were followed within the Swiss HIV Cohort Study (SHCS). We assessed patients' virological success after their antiretroviral therapy was switched following resistance testing. Multilevel logistic regression models with SHCS centre as a random effect were used to investigate the association between the type of resistance test and virological response (HIV-1 RNA<50 copies/mL or [greater than or equal to]1.5log reduction). RESULTS: Of 1158 individuals with resistance tests 221 with GRT+rPRT and 937 with GRT were eligible for analysis. Overall virological response rates were 85.1% for GRT+rPRT and 81.4% for GRT. In the subgroup of patients with >2 previous failures, the odds ratio (OR) for virological response of GRT+rPRT compared to GRT was 1.45 (95% CI 1.00-2.09). Multivariate analyses indicate a significant improvement with GRT+rPRT compared to GRT alone (OR 1.68, 95% CI 1.31-2.15). CONCLUSIONS: In heavily pre-treated patients rPRT-based resistance information adds benefit, contributing to a higher rate of treatment success.