Clinical utility of testing human immunodeficiency virus for drug resistance

Human immunodeficiency virus (HIV) type 1 drug-resistance testing is quickl y moving from the research laboratory to the clinic as data defining its ut ility as a prognostic indicator of response to therapy become available. In July 1998, a panel of the International AIDS Society-USA did not recommend the widespread application of resistance testing, but by May 2000 this pan el endorsed and recommended the incorporation of resistance testing in pati ent-care management. Considerable data supporting the use of drug-resistanc e testing have now been published or presented at international conferences . These data strongly suggest that drug-resistance testing is of considerab le value in many clinical settings. Prospective trials of resistance testin g as a clinical management tool are still ongoing, and the long-term benefi ts still need to be evaluated. Nevertheless, early results from several stu dies showed a significantly better virological response when treatment regi mens were based on resistance-testing data, rather than on the standard of care. HIV drug-resistance testing is also useful as a tool for new antiretr oviral drug design and development, as well as for monitoring the spread of primary HIV drug resistance.