Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
J Clin Microbiol. 2024 Aug 14;62(8):e0072823. doi: 10.1128/jcm.00728-23. Epub 2024 Jul 25.
The laboratory diagnosis of antiviral resistance is a quickly changing field due to new drug availability, the sunsetting of older drugs, the development of novel technologies, rapid viral evolution, and the financial/logistic pressures of the clinical laboratory. This mini-review summarizes the current state of clinically available antiviral resistance testing in the United States in 2024, covering the most commonly used test methods, mechanisms, and clinical indications for herpes simplex virus, cytomegalovirus, human immunodeficiency virus, influenza, hepatitis B virus, and hepatitis C virus drug resistance testing. Common themes include the move away from phenotypic to genotypic methods for first-line clinical testing, as well as uncertainty surrounding the clinical meaningfulness of minority variant detection as next-generation sequencing methods have become more commonplace.
由于新药物的出现、旧药物的淘汰、新技术的发展、病毒的快速进化以及临床实验室的财务/物流压力，抗病毒药物耐药性的实验室诊断是一个快速变化的领域。这篇迷你综述总结了 2024 年美国目前临床可用的抗病毒耐药性检测情况，涵盖了单纯疱疹病毒、巨细胞病毒、人类免疫缺陷病毒、流感、乙型肝炎病毒和丙型肝炎病毒耐药性检测中最常用的检测方法、机制和临床适应证。常见的主题包括从表型方法向一线临床检测的基因型方法转变，以及随着下一代测序方法变得越来越普遍，少数变异检测的临床意义的不确定性。
