Wensing Annemarie M, Charpentier Charlotte, Calvez Vincent, Ceccherini-Silberstein Francesca, Günthard Huldrych F, Jacobsen Donna M, Paredes Roger, Shafer Robert W, Richman Douglas D
Department of Global Health and Bio-Ethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands and Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Paris Cité University and Bichat-Claude Bernard Hospital, France.
Clin Infect Dis. 2025 Apr 3. doi: 10.1093/cid/ciaf161.
The improved efficacy and tolerability of newer antiretroviral drugs, as well as the introduction of long-acting regimens, have prompted more frequent therapy switches in individuals on suppressive antiretroviral therapy (ART). For these individuals, the assessment of HIV drug resistance using DNA from peripheral blood lymphocytes has become increasingly popular. However, compared with HIV RNA-based analyses, implementation of HIV DNA testing as an alternative approach in clinical care requires new documented quality assessment procedures and clinical validation. Furthermore, the use of HIV DNA to assess drug resistance has some distinct technical and biologic challenges that are relevant to the clinical management of people with HIV. This viewpoint article addresses the issues relevant to clinical virologists and treating physicians for interpretation of drug resistance testing or subtype assessment based on DNA analysis, when HIV RNA genotypic assessment is not possible.
新型抗逆转录病毒药物疗效和耐受性的提高，以及长效治疗方案的引入，促使接受抑制性抗逆转录病毒治疗（ART）的患者更频繁地更换治疗方案。对于这些患者，利用外周血淋巴细胞中的DNA评估HIV耐药性越来越普遍。然而，与基于HIV RNA的分析相比，将HIV DNA检测作为临床护理中的替代方法实施，需要新的有记录的质量评估程序和临床验证。此外，使用HIV DNA评估耐药性存在一些独特的技术和生物学挑战，这些挑战与HIV感染者的临床管理相关。这篇观点文章探讨了在无法进行HIV RNA基因分型评估时，临床病毒学家和治疗医生在基于DNA分析解释耐药性检测或亚型评估时相关的问题。
