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June 1, 2000AIDS

A randomized study of antiretroviral management based on plasma genotypic antiretroviral resistance testing in patients failing therapy

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Authors

JBJohn D. BaxterCooper Medical School of Rowan UniversityDMDouglas L. MayersDoylestown HospitalDWDeborah WentworthUniversity of Minnesota

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Implication

Randomized trial demonstrates greater viral load reductions with resistance testing in failing HIV therapy, highlighting the clinical value of genotype-guided treatment decisions.

Key Points

  • To evaluate the short-term virologic efficacy of genotypic antiretroviral resistance testing combined with expert advice in HIV-infected patients failing combination antiretroviral therapy.
  • Prospective multicenter randomized controlled trial of 153 HIV-infected adults experiencing treatment failure (threefold or greater rise in plasma HIV-1 RNA) on at least 16 weeks of combination therapy with a protease inhibitor and two nucleoside reverse transcriptase inhibitors.
  • Patients were randomized to receive treatment informed by genotypic antiretroviral resistance testing (GART) with expert interpretation (n=78) or standard care without genotype input (n=75), with follow-up at 4, 8, and 12 weeks.
  • Mean HIV-1 RNA reductions averaged at weeks 4 and 8 were -1.19 log10 in the GART group versus -0.61 log10 in the control group, representing a significant treatment difference of -0.53 log10 (95% CI, -0.77 to -0.29; P = 0.00001).
  • The strongest virologic improvements were observed among patients who received three or more antiretroviral medications to which their viral isolate was fully susceptible.

Cite This Study

Baxter et al. (2000) studied this question.

synapsesocial.com/papers/6a08c2ac5686deba6901e970https://doi.org/10.1097/00002030-200006160-00001
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