Second Spanish Consensus on the Use of Drug Resistance Testing in Clinical Practice (Madrid, March 2000)
Vicente Soriano 1, Emilio Ledesma 2, The Spanish Drug Resistance Panel 2
1 UNIR Health Sciences School and Medical Center, Universidad Internacional de La Rioja, Madrid, Spain; 2 NULL
*Correspondence: Emilio Ledesma, Email not available
Abstract
A workshop was organized in Madrid on March 2000 to update recommendations for the use of drug resistance testing in HIV infection in Spain, based on new information and tests currently available. A panel of 30 physicians with wide experience in the field of antiretroviral therapy and/or resistance testing convened in a full-day session. Available clinical and laboratory data reported in the medical literature, conferences, and panel expert opinion were presented and discussed in an open fashion. The panel agreed to identify situations in which resistance testing should be recommended, others in which it might be considered, and others in which it should not be used. In summary, drug resistance testing should be recommended in HIV-positive pregnant women, in children (infected) born to treated mothers, in primary HIV infection or recent seroconversion, in early virological treatment failures, and before introducing a salvage regimen in heavily pre-treated subjects. Two situations were recognized in which resistance testing might be considered: in chronic naive infected subjects before beginning therapy, and in post-exposure prophylaxis. Lastly, testing should not be recommended when no treatment options exist for a given patient, or when plasma viremia is below the limit of detection. In summary, specific situations have been identified in which drug resistance testing might be of value for choosing antiretroviral therapy either in naive or pre-treated subjects. The advantages of this new tool remain controversial in any other circumstances.
