HIV Resistance Testing in Clinical Practice: A QALY-fied Success
Authors: Michael S. Saag
Journal: Annals of Internal Medicine (2001)

Editorials20 March 2001HIV Resistance Testing in Clinical Practice: A QALY-fied SuccessMichael S. Saag, MDMichael S. Saag, MDDr. Saag: University of Alabama at Birmingham; Birmingham, AL 35294-2050Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-134-6-200103200-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Despite the significant advances in HIV therapy over the past 5 years, failure of highly active antiretroviral therapy (HAART) remains a significant problem. In a meta-analysis of 21 treatment groups from randomized clinical studies, only 46% of patients were able to reach the targeted HIV RNA viral load (<50 copies/mL) by 48 weeks (1). Because of virologic rebound or toxicity, the initial regimen ultimately fails even in most patients who are at first treated successfully. Therefore, HAART failure is common and should be anticipated by all clinicians caring for HIV-infected patients.The management of HAART failure depends on the reason ...References1. Bartlett JA, DeMasi R, Quinn J, Moxham C, Rousseau F. Meta-analysis of efficacy of triple combination therapy in antiretroviral naïve HIV infected adults [Abstract]. Seventh Conference on Retroviruses and Opportunistic Infections. San Francisco, California, 30 January–2 February 2000. Alexandria, VA: Foundation for Retrovirology and Human Health; 2000. Abstract no. 519. Google Scholar2. Carpenter CC, Fischl MA, Hammer SM, Hirsch MS, Jacobsen DM, Katzenstein DA, et al. . Antiretroviral therapy for HIV infection in 1998: updated recommendations of the International AIDS Society-USA Panel. JAMA. 1998;280:78-86. [PMID: 0009660368] CrossrefMedlineGoogle Scholar3. Call SA, Saag MS, Westfall AO, Raper JL, Pham SV, Tolson JM, et al. . 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Moore RD, Bartlett JG. Combination antiretroviral therapy in HIV infection. An economic perspective. Pharmacoeconomics. 1996;10:109-13. [PMID: 0010163413] CrossrefMedlineGoogle Scholar16. Tural C, Ruiz L, Holtzer C, Viciana P, Gonzalez J, Ferrer E, et al. The clinical utility of HIV genotyping: the Havanna Trial [Abstract]. 40th Interscience Conference on Antimicrobial Agents and Chemotherapy, Toronto, Canada, September 2000. Washington, DC: American Soc for Microbiology; 2000. Abstract no. L-10. Google Scholar Author, Article, and Disclosure InformationAffiliations: Dr. Saag: University of Alabama at Birmingham; Birmingham, AL 35294-2050Disclaimer: Dr. Saag has served as a consultant for three companies (Virco, ViroLogics, and Roche Diagnostics) involved in the development, manufacturing, or sale of products used in HIV resistance testing. In addition, he has collaborated with Virco and ViroLogics in clinical trials designed to evaluate the effectiveness of HIV resistance testing among patients followed in a clinical cohort.Corresponding Author: Michael S. Saag, MD, University of Alabama at Birmingham, CCB Room 178, 908 20th Street South, Birmingham, AL 35294-2050. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUse of Genotypic Resistance Testing To Guide HIV Therapy: Clinical Impact and Cost-Effectiveness Milton C. Weinstein , Sue J. Goldie , Elena Losina , Calvin J. Cohen , John D. Baxter , Hong Zhang , April D. Kimmel , and Kenneth A. Freedberg Metrics Cited ByPerceptions of Health and Self-Care Learning Needs of Outpatients With HIV/AIDSA sensitive genotyping assay for detection of drug resistance mutations in reverse transcriptase of HIV-1 subtypes B and C in samples stored as dried blood spots or frozen RNA extractsHIV resistance testing in the USA – a model for the application of pharmacogenomics in the clinical settingEconomic implication of HIV-1 resistance testing in overall clinical careWhat can oncologists learn from HIV?HIV therapy in 2003The pharmacogenomics of HIV therapy 20 March 2001Volume 134, Issue 6Page: 475-477KeywordsAttentionClinical trialsDrugsHIVPatientsProphylaxisQuality adjusted life yearsTherapeutic drug monitoringToxicityViral load ePublished: 20 March 2001 Issue Published: 20 March 2001 CopyrightCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...