US HIV treatment guidelines have been updated to include a recommendation that all HIV-positive patients should have a genotypic resistance test before starting anti-HIV therapy.
The previous edition of the US guidelines only recommended resistance tests for patients with long-term HIV infection. However, an amendment to the Department of Health and Human Services’s Guidelines for the Use of Antiretroviral Agents in HIV-1 Infected Adults and Adolescents issued on May 4th recommends that patients with chronic HIV infection and those with acute HIV infection should have resistance tests before antiretroviral therapy is initiated.
Research suggesting that as many as 16% of patients newly diagnosed with HIV are infected with drug resistant virus prompted the change in the US guidelines, which note that using resistance tests can help select the most appropriate anti-HIV treatment regimen and avoid the use of drugs to which an individual is resistant.
The treatment guidelines of the British HIV Association recommend that all HIV-positive patients should have a genotypic resistance tests before commencing antiretroviral therapy. A study conducted in Germany and recently reported on aidsmap.com noted that antiretroviral naïve-patients with primary drug resistance who had their anti-HIV therapy selected after resistance testing had as favourable a response to first-line HIV treatment as patients with wild-type HIV.