First European guidelines for HIV-1 drug resistance testing (2001)

The first European guidelines on HIV-1 drug resistance testing have been published in the February edition of the authoritative peer review journal AIDS (Vol 15 No 3, February 2001).

The guidelines, produced by the EuroGuidelines Group (EGG), were developed to help clinicians decide when and how to employ new diagnostic tests that indicate levels of HIV drug susceptibility in those being treated for HIV disease. In particular, the guidelines will help clinicians decide which combinations of drugs are most appropriate when initiating treatment, for those who have failed one or more previous drug regimens, and for optimal antiretroviral therapy in children and during pregnancy.

Launching the guidelines, Veronica Miller, a member of the EGG from the Centre for Internal Medicine at J W Goethe University in Frankfurt, said: “HIV-1 drug resistance testing could have a major role to play in patient care in the future. At present, however, there are no common guidelines throughout Europe and no consistency in terms of technology, reporting or reimbursement of resistance testing. These guidelines seek to address this situation for the first time.”

In addition to guidance on the interpretation of HIV resistance tests, the guidelines also provide recommendations on procedures for sample collection, how to select a laboratory at which test samples are to be analysed and the level of reporting clinicians should expect from their chosen laboratories.

While the guidelines mark an important step forward there is still more to be done, according to the EGG. It makes two key recommendations:

  1. That a European-wide tracking system be developed to monitor transmission of HIV-1 drug resistance in different geographical regions and/or risk groups.
  2. That a major educational drive be undertaken to communicate both the value of resistance testing and the overall goal of an equal standard of care for people with HIV throughout Europe.

“Progress in technology and improvements in our understanding of HIV disease and treatment have increased the feasibility of resistance testing in routine clinical care,” added Dr Miller. “Taking a lead from the world of microbiology, where antimicrobial resistance testing is routine, HIV-1 resistance testing may soon become standard practice in HIV treatment management, leading to better clinical and virological outcomes for all patients.”

Source: EGG press release

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