Cane P A, Kaye S, Smit E, Tilston P, Kirk S, Shepherd J, Hopkins M, Zhang H, Geretti A M
Virus Reference Department, Centre for Infections, Health Protection Agency, London, UK.
HIV Med. 2008 Oct;9(8):673-6. doi: 10.1111/j.1468-1293.2008.00607.x. Epub 2008 Jun 28.
Antiretroviral drug resistance testing is recommended in HIV-1 infected patients failing therapy in order to inform treatment selection. Although guidelines and test manufacturers recommend a viral load of at least 500-1000 HIV-1 RNA copies/mL for genotypic resistance testing to be performed, prompt management of virological failure could benefit from testing at lower viral load levels.
Laboratories undertaking genotypic resistance testing were asked to provide figures for the number of resistance tests undertaken at viral loads <2000 copies/mL, the success rates of such tests and the extent of resistance detected, all stratified for viral load levels.
Of the replies received, most laboratories were attempting resistance testing at viral loads below the recommended guidelines, with variable success and outcomes.
This audit of current practice in the UK for undertaking genotypic resistance tests at viral loads <1000 copies/mL highlights the widespread use of such testing outside the British HIV Association guidelines.
对于接受抗逆转录病毒治疗失败的HIV-1感染患者，建议进行耐药性检测，以便为治疗选择提供依据。尽管指南和检测制造商建议进行基因型耐药性检测时病毒载量至少为500-1000 HIV-1 RNA拷贝/毫升，但在较低病毒载量水平进行检测可能有助于及时处理病毒学失败情况。
要求进行基因型耐药性检测的实验室提供病毒载量<2000拷贝/毫升时进行的耐药性检测数量、此类检测的成功率以及检测到的耐药程度数据，所有数据均按病毒载量水平分层。
在收到的回复中，大多数实验室都在尝试在低于推荐指南的病毒载量下进行耐药性检测，成功率和结果各不相同。
此次对英国当前在病毒载量<1000拷贝/毫升时进行基因型耐药性检测的实践情况的审核表明，此类检测在英国HIV协会指南之外被广泛使用。
