TABLE 2.
Prospective intervention studies comparing HIV resistance testing to physician-guided therapy
| Studya (reference) | Previous treatment | No. of patients | Study duration (wk) | RNA change (log10 copies/ml)
|
Comment | ||
|---|---|---|---|---|---|---|---|
| PGTb | Genotypic | Phenotypic | |||||
| GART (19) | ≥16 wk of 2 NRTIs and 1 PI | 153 | 12 | −0.61 | 1.19 | ND | |
| Havana (380a) | ≥24wk of heavy treatment | 326 | 24 | −0.63 | −0.84 | ND | Expert advice added benefit to genotypic testing |
| −0.99 | −1.45 | ND | |||||
| VIRA 3001 (50a) | ≥2 NRTIs and 1 PI | 272 | 16 | −0.87 | ND | −1.23 | |
| VIRADAPT (92) | ≥24wk of NRTI and 12wk of PIs | 108 | 24 | −0.67 | −1.15 | ND | Benefit maintained for 9-12 months |
| Kaiser | >12wk of heavy treatment, NNRTI naïve | 115 | 16 | NSD | NSD | ||
| NARVAL | Heavy treatment (median, 7 drugs) | 541 | 12 | NSD | NSD | NSD | Genotypic testing had significant benefit at 24 wk |
| ARGENTAc (47a) | Variable treatment (41% received NRTIs, PIs, and NNRTIs) | 174 | 24 | −0.39 | −0.57 | ND | Genotypic testing more effective in patients with plasma HIV-1 RNA <10,000 copies/ml |
| CCTG 575 (139) | ≥24 wk of treatment, 1-2 prior PIs, 76% NNRTI naive | 238 | 24 | −0.69 | ND | −0.71 | Phenotypic testing was associated with better outcome in a subgroup with >5 yr of treatment |
a
GART, Genotypic Antiretroviral Resistance Testing; ARGENTA, Antiretroviral Genotypic Resistance and Patient Reported Adherence Study. Kaiser study, Melnick et al., 7th Conf. on Retroviruses, abstr. 786, 2000; NARVAL, Meynard et al., 40th ICAAC, abstr. 698, 2000. The Virco Antivirogram was used in the VIRA 3001 and Kaiser studies. A different recombinant virus assay was used in NARVAL.
b
PGT, physician-guided therapy. NSD, no significant difference. ND, not determined.
c
At week 12, genotypic more effective than PGT (27 versus 12%, P = 0.02), but at week 24, no significant difference.