Web Resources for HIV Type 1 Genotypic-Resistance Test Interpretation

TLDR

Interpreting HIV‑1 genotypic drug‑resistance test results is challenging because of numerous mutations, complex resistance patterns, and viral diversity, making interpretation systems essential to assess clinical significance. The study aims to explain the scientific principles behind HIV‑1 genotypic‑resistance test interpretation and to catalog the most widely used web‑based resources for clinicians. The authors review the scientific principles of HIV‑1 genotypic‑resistance test interpretation and identify the most commonly used web‑based resources.

Abstract

Interpreting the results of plasma human immunodeficiency virus type 1 (HIV-1) genotypic drug-resistance tests is one of the most difficult tasks facing clinicians caring for HIV-1-infected patients. There are many drug-resistance mutations, and they arise in complex patterns that cause varying levels of drug resistance. In addition, HIV-1 exists in vivo as a virus population containing many genomic variants. Genotypic-resistance testing detects the drug-resistance mutations present in the most common plasma virus variants but may not detect drug-resistance mutations present in minor virus variants. Therefore, interpretation systems are necessary to determine the phenotypic and clinical significance of drug-resistance mutations found in a patient's plasma virus population. We describe the scientific principles of HIV-1 genotypic-resistance test interpretation and the most commonly used Web-based resources for clinicians ordering genotypic drug-resistance tests.