Sen Sourav, Tripathy S P, Paranjape R S
National AIDS Research Institute, (Indian Council of Medical Research), Pune, Maharashtra, India.
J Postgrad Med. 2006 Jul-Sep;52(3):187-93.
While antiretroviral drugs, those approved for clinical use and others under evaluation, attempt in lowering viral load and boost the host immune system, antiretroviral drug resistance acts as a major impediment in the management of human immune deficiency virus type-1 (HIV-1) infection. Antiretroviral drug resistance testing has become an important tool in the therapeutic management protocol of HIV-1 infection. The reliability and clinical utilities of genotypic and phenotypic assays have been demonstrated. Understanding of complexities of interpretation of genotyping assay, along with updating of lists of mutation and algorithms and determination of clinically relevant cut-offs for phenotypic assays are of paramount importance. The assay results are to be interpreted and applied by experienced HIV practitioners, after taking into consideration the clinical profile of the patient. This review sums up the methods of assay currently available for measuring resistance to antiretroviral drugs and outlines the clinical utility and limitations of these assays.
虽然抗逆转录病毒药物,包括那些已批准用于临床的药物和其他正在评估的药物,试图降低病毒载量并增强宿主免疫系统,但抗逆转录病毒药物耐药性是人类免疫缺陷病毒1型(HIV-1)感染管理中的一个主要障碍。抗逆转录病毒药物耐药性检测已成为HIV-1感染治疗管理方案中的一项重要工具。基因分型和表型分析的可靠性及临床实用性已得到证实。了解基因分型分析解释的复杂性,更新突变列表和算法,以及确定表型分析的临床相关临界值至关重要。检测结果应由经验丰富的HIV从业者在考虑患者临床情况后进行解释和应用。本综述总结了目前可用于检测对抗逆转录病毒药物耐药性的检测方法,并概述了这些检测方法的临床实用性和局限性。