AIDSWEEKLY Plus; Monday, June 4, 2001
Michael Greer, Staff Medical Writer

NewsRx - Genotypic-resistance testing (GRT) can successfully point doctors to effective antiretroviral drugs for HIV treatment, according to researchers in Germany.

"Resistance-associated mutations in HIV-1 evolve even under highly active antiretroviral therapy," B. Zollner and colleagues at the University of Krakenhaus Eppendorf explained in the Journal of Clinical Virology.

Zollner and associates found that GRT provides an accurate estimate of a particular drug's potential to prevent further resistance-conferring mutations.

Patients whose treatment was based on GRT results (group 1, n = 5) achieved an average reduction in plasma HIV RNA levels of 1.35 log/mL, they said. These patients also showed a significant decline in the number of productively infected CD4⁺ cells although they did not realize a significant increase in the number of uninfected CD4⁺ cells.

However, patients whose treatment would not be recommended by their GRT results (group 2, n = 5) did not experience a significant reduction in viral load. Moreover, these patients showed a significant elevation in the number of productively infected CD4⁺ cells, while the number of functioning CD4⁺ cells declined, study data showed.

While patients in group 1 did not demonstrate any resistance-conferring HIV mutations over the course of eight months, four of the five group 2 patients had additional reverse transcriptase gene mutations granting resistance to multiple drugs ("Application of HIV-1 genotypic-resistance testing prevents the evolution of further resistance mutations in heavily pretreated patients," J Clin Virol 2001 Apr;21(1):37-45.

"GRT is predictive of the efficacy of a therapeutic regimen, in particular regarding evolution of further resistance mutations," Zollner and colleagues concluded.

The corresponding author for this report is B. Zollner, University of Krankenhaus Eppendorf, Institute for Medical Microbiology and Immunology, Martinistrasse 52, D-20246 Hamburg, Germany.

A search at www.NewsRx.net using the term "AIDS and HIV therapy" yielded 1,191 articles in six specialized reports.

Key points reported in this study include:

• Genotypic-resistance testing (GRT) provides an accurate estimate of antiretroviral drugs' potential for preventing resistance mutations in HIV
  
  
• Patients with GRT-recommended treatments had reduced viral load and showed no such mutations
  
  
• Patients treated with drugs not recommended by GRT, however, experienced no disease improvement
  
  
• Moreover, these patients were likely to develop resistance mutations for multiple drugs
  

This article was prepared by AIDS Weekly editors from staff and other reports.

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