Laboratory Guidelines for the Practical Use of HIV Drug Resistance Tests in Patient Follow-Up
Laboratory Guidelines for the Practical Use of HIV Drug Resistance Tests in Patient Follow-Up
复制标题
HIV 耐药性测试在患者随访中实际应用的实验室指南
DOI：
10.1177/135965350100600103
复制
发表时间：
2001
影响因子：
1.2
通讯作者：
Veronica Miller
中科院分区：
文献类型：
--
作者：
A. Vandamme;François Houÿez;Dénes Bánhegyi;B. Clotet;G. Schrijver;K. D. Smet;William W. Hall;Richard Harrigan;N. Hellmann;K. Hertogs;C. Holtzer;B. Larder;Deenan Pillay;E. Race;J. Schmit;Rob Schuurman;E. Shulse;A. Sönnerborg;Veronica Miller
艾滋病毒耐药性是目前可用的抗逆转录病毒联合疗法成功治疗艾滋病毒感染患者的主要限制之一。适当时，在选择特定联合治疗时应考虑到药物敏感性。建议在某些情况下进行耐药性测试的指南已经发布。许多临床医生可以获得耐药性测试，并将越来越多地在治疗决策中使用这些结果。在本文中，我们评论了不同的可用方法，以及与这些测试的临床应用相关的问题。具体来说，可以提出以下建议：(i)基因型和表型HIV-1耐药分析可以为临床医生提供补充信息。然而，目前没有足够的信息表明哪种方法在任何特定的临床环境中更可取；（ii）当需要进行HIV-1耐药检测时，建议对在开始、停止或改变治疗之前获得的血浆样本，以及病毒载量高于耐药检测极限的样本进行检测；（iii）专家组建议在经过认证的实验室中按照严格的质量控制和质量保证标准进行临床目的的基因型和表型HIV-1耐药性检测；（iv）专家组建议耐药检测实验室向临床医生提供耐药报告，其中包括与药物相关的耐药突变（基因型）清单和/或与药物相关的多重耐药值（表型）清单，并由经验丰富的病毒学家对每一项进行解释。基因型和表型分析的解释是一门复杂而发展中的科学，为了理解HIV-1耐药报告，建议提出请求的临床医生与耐药报告的解释专家进行沟通。
HIV drug resistance is one of the major limitations in the successful treatment of HIV-infected patients using currently available antiretroviral combination therapies. When appropriate, drug susceptibility profiles should be taken into consideration in the choice of a specific combination therapy. Guidelines recommending resistance testing in certain circumstances have been issued. Many clinicians have access to resistance testing and will increasingly use these results in their treatment decisions. In this document, we comment on the different methods available, and the relevant issues relating to the clinical application of these tests. Specifically, the following recommendations can be made: (i) genotypic and phenotypic HIV-1 drug resistance analyses can yield complementary information for the clinician. However, insufficient information currently exists as to which approach is preferable in any particular clinical setting; (ii) when HIV-1 drug resistance testing is required, it is recommended that testing be performed on plasma samples obtained before starting, stopping or changing therapy, on samples that have a viral load above the detection limit of the resistance test; (iii) the panel recommends that genotypic and phenotypic HIV-1 drug resistance testing for clinical purposes be performed in a certified laboratory under strict quality control and quality assurance standards; and (iv) the panel recommends that resistance testing laboratories provide clinicians with resistance reports that include a list of drug-related resistance mutations (genotype) and/or a list of drug-related fold resistance values (phenotype), with interpretations of each by an experienced virologist. The interpretation of genotypic and phenotypic analysis is a complex and developing science, and in order to understand HIV-1 drug resistance reports, communication between the requesting clinician and the expert that interpreted the resistance report is recommended.
登录
查看更多内容
影响因子：
158.5
作者：
Gulick, RM;Mellors, JW;Chodakewitz, JA
通讯作者：
Chodakewitz, JA
人类免疫缺陷病毒 1 型逆转录酶中的序列簇与随后抗逆转录病毒治疗的病毒学反应相关。
DOI：
10.1086/315017
发表时间：
1999
期刊：
The Journal of infectious diseases.
影响因子：
--
作者：
Brown,AJ;Gunthard,HF;Wong,JK;D'Aquila,RT;Johnson,VA;Kuritzkes,DR;Richman,DD
通讯作者：
Richman,DD
DOI：
10.1056/nejm199512073332204
发表时间：
1995-12
期刊：
The New England journal of medicine
影响因子：
--
作者：
M. Markowitz;M. Saag;W. Powderly;A. Hurley;A. Hsu;J. Valdes;D. Henry;F. Sattler;Anthony F. La Marca;J. Leonard;D. Ho
通讯作者：
M. Markowitz;M. Saag;W. Powderly;A. Hurley;A. Hsu;J. Valdes;D. Henry;F. Sattler;Anthony F. La Marca;J. Leonard;D. Ho
影响因子：
6.4
作者：
HAVLIR, D;CHEESEMAN, SH;RICHMAN, DD
通讯作者：
RICHMAN, DD
精液中的人类免疫缺陷病毒源自遗传上不同的病毒库。
DOI：
--
发表时间：
1998
期刊：
AIDS research and human retroviruses.
影响因子：
--
作者：
Kiessling,AA;Fitzgerald,LM;Zhang,D;Chhay,H;Brettler,D;Eyre,RC;Steinberg,J;McGowan,K;Byrn,RA
通讯作者：
Byrn,RA