Antiretroviral Drug Resistance Testing in Adults Infected with Human Immunodeficiency Virus Type 1: 2003 Recommendations of an International AIDS Society–USA Panel

TLDR

New information about the benefits and limitations of HIV‑1 drug resistance testing has emerged, but limitations remain and further study is needed to refine its optimal use and interpretation. An International AIDS Society‑USA panel of experts reviewed published data, conference presentations, and evidence strength to update recommendations for HIV‑1 resistance testing. Properly used resistance testing improves virological outcomes and is recommended for acute or recent infection, patients infected for up to 2 years before therapy, antiretroviral failure cases, and during pregnancy.

Abstract

New information about the benefits and limitations of testing for resistance to human immunodeficiency virus (HIV) type 1 (HIV-1) drugs has emerged. The International AIDS Society-USA convened a panel of physicians and scientists with expertise in antiretroviral drug management, HIV-1 drug resistance, and patient care to provide updated recommendations for HIV-1 resistance testing. Published data and presentations at scientific conferences, as well as strength of the evidence, were considered. Properly used resistance testing can improve virological outcome among HIV-infected individuals. Resistance testing is recommended in cases of acute or recent HIV infection, for certain patients who have been infected as long as 2 years or more prior to initiating therapy, in cases of antiretroviral failure, and during pregnancy. Limitations of resistance testing remain, and more study is needed to refine optimal use and interpretation.