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HIV-1 Resistance in Supervised Treatment Settings. Edition No. 1
VDM Publishing House, Sep 2008, Pages: 188
Positive treatment outcomes for patients with Human
Immunodeficiency Virus-1 (HIV-1) disease may be
compromised by the selection of HIV-1 drug resistant
mutants (HIVDRM), particularly in marginalized
populations where fragmented care is prevalent.
Adherence as an important co-factor in selecting
HIVDRMs has been controversial. Thus, understanding
the causes and effects of HIVDRMs in the context
adherence is provocative. In this monograph, we
synthesize the literature on antiretroviral
resistance testing and discuss its use as a public
health tool. We conducted an investigation of the
resistance testing effects on treatment outcomes
among patients with late stage HIV-1 disease in
supervised treatment settings in NYC. The genotypic
sensitivity score (GSS), a summary measure of regimen
potency in the context of HIVDRM was examined for its
predictive effects on treatment outcomes, emergence
of resistance and viral evolution. While a higher GSS
was positively, independently associated with viral
suppression, the measure was not predictive of
immunologic, clinical, subsequent appearance of
HIVDRMs or viral evolution in this supervised
treatment setting.
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