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Initiatives for developing and comparing genotype interpretation systems: external validation of existing rule‐based interpretation systems for abacavir against virological response †
Author(s) -
CozziLepri A
Publication year - 2008
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2008.00523.x
Subject(s) - abacavir , concordance , interquartile range , medicine , viral load , confidence interval , drug resistance , virology , human immunodeficiency virus (hiv) , antiretroviral therapy , biology , genetics
Objectives To investigate the concordance between any of the results of nine HIV‐1 drug‐resistance interpretation systems (ISs) and their ability to predict week 8 and week 24 virological responses to abacavir‐containing combination therapy. Patients and Methods A total of 1306 HIV‐infected patients with a viral load >500 HIV‐1 RNA copies/mL and a baseline genotypic resistance test were included in the study. Predicted abacavir susceptibilities according to each rule‐based IS were compared. Linear and logistic regressions were used to assess the prognostic value of each IS for week 8 and week 24 responses, respectively. Results A median of three (interquartile range 1–5) abacavir mutations were detected at baseline. Comparing the IS predictions for abacavir susceptibility, 9% to 45% of patients were predicted to have resistant (R) virus, 9% to 53% virus with intermediate (I) resistance, and 23% to 74% susceptible (S) virus. Overall, the median week 8 viral load reduction was 1.61 log 10 copies/mL (95% confidence interval 1.52–1.71) and 50% of patients experienced virological failure at 24 weeks. Most ISs showed better virological responses with S and I viruses than with R viruses. Conclusions Despite some degree of variability in predicted abacavir susceptibility among ISs, most ISs are useful to predict virological response.