Tests that measure whether the strains of HIV infecting a patient are resistent to antiviral drugs may be useful in helping plan treatment strategies, but more information is needed to determine the best usage of such tests, says an international panel of AIDS experts. In a report appearing in the June 24 issue of the Journal of the American Medical Association, the panel convened by the International AIDS Society-USA outlines several implications of and recommendations regarding testing for drug resistance in HIV. The study's lead author is Martin Hirsch, MD, director of Clincal AIDS Research at the Massachusetts General Hospital and professor of Medicine at Harvard Medical School (HMS).
"It is clear that viral resistance, the existence or development of strains of HIV that can escape the effects of particular antiviral drugs, is an important reason why drug treatment fails some patients," Hirsch says. "While there is not yet enough data available to recommend which of the available tests is best in particular situations, we do believe that resistance information may be useful in guiding treatment, particularly in areas where resistant strains are prevalent."
The panel was made up of 13 physicians from six countries, experts in AIDS treatment and in research relevant to the issue of resistance. The group was convened by the International AIDS Society-USA as part of their effort to monitor and address areas of controversy in the treatment of HIV-related disease. The panel reviewed existing information from published reports, research conference presentations, basic and clinical research studies and information from the manufacturers of available resistance assays and met regularly over a six-month period to develop their report.
Among the group's conclusions are the following: