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Cited by 563

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Antiretroviral Drug Resistance Testing in Adults With HIV Infection: Implications for Clinical Management

Hirsch, Martin S., Conway, Brian, D'Aquila, Richard T., Johnson, Victoria A., Brun-Vézinet, Françoise, Clotet, Bonaventura, Demeter, Lisa M., Hammer, Scott M., Jacobsen, Donna M., Kuritzkes, Daniel R., Loveday, Clive, Mellors, John W., Vella, Stefano, Richman, Douglas D., for the International AIDS Society–USA Panel·1998·JAMA

Abstract

OBJECTIVES: To review current knowledge of the biology and clinical implications of human immunodeficiency virus (HIV) resistance to antiretroviral drugs, describe assays for measuring resistance, and assess their use in clinical practice. PARTICIPANTS: The International AIDS Society-USA assembled a panel of 13 physicians with expertise in basic science, clinical research, and patient care relevant to HIV resistance to antiretroviral drugs. EVIDENCE: We reviewed available data from published reports and presented at national and international research conferences. Basic science research, clinical trial results, and expert opinions were used to form the basis of this report. Data on methods for and characteristics of specific genotypic and phenotypic assays were obtained from manufacturers and service providers. CONSENSUS PROCESS: The panel met regularly between October 1997 and April 1998. Panel subgroups developed and discussed different sections of the report before discussing them with the entire panel. Conclusions and suggested approaches to the use of resistance testing were determined by group consensus. CONCLUSIONS: Plasma HIV RNA level and CD4+ cell count are the primary values that should be used to guide the initiation of antiretroviral therapy and subsequent changes in therapy. Possible causes of treatment failure other than development of drug resistance that should be considered are adherence, drug potency, and pharmacokinetic issues. Genotypic and phenotypic testing for HIV resistance to antiretroviral drugs may prove useful for individual patient management. Assays under development need validation, standardization, and a clearer definition of their clinical roles. Possible current roles of resistance testing for choosing an initial regimen or changing antiretroviral therapy, as well as possible implications of the presence or absence of phenotypic resistance and genotypic changes, are discussed.

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Metadata

Authors
Hirsch, M. S., Conway, B., D'Aquila, R. T., Johnson, V. A., Brun-Vézinet, F., Clotet, B., Demeter, L. M., Hammer, S. M., Jacobsen, D. M., Kuritzkes, D. R., Loveday, C., Mellors, J. W., Vella, S., Richman, D. D., & for the International AIDS Society–USA Panel
Venue
JAMA
Published
1998-06-24
Volume
279
Issue
24
Pages
1984
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
OpenAlex
W2139266935
Cited by
563
References
2
FWCI
79.93
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Antiretroviral Drug Resistance Testing in Adults With HIV Infection: Implications for Clinical Management. https://app.cochat.ai/papers/10.1001/jama.279.24.1984
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Hirsch, M. S., Conway, B., D'Aquila, R. T., Johnson, V. A., Brun-Vézinet, F., Clotet, B., Demeter, L. M., Hammer, S. M., Jacobsen, D. M., Kuritzkes, D. R., Loveday, C., Mellors, J. W., Vella, S., Richman, D. D., & for the International AIDS Society–USA Panel. (1998). Antiretroviral Drug Resistance Testing in Adults With HIV Infection: Implications for Clinical Management. JAMA. https://doi.org/10.1001/jama.279.24.1984

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.