HIV-1 resistance testing influences treatment decision-making
Objective: To investigates how the use of HIV-1 resistance tests influences physician decision-making. Methods: Ten experienced reference physicians from the Brazilian Network for Drug Resistance each received ten patients’ case histories. The selected patients had experienced at least two virologic...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2010-09-01
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| Series: | Brazilian Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867010700982 |
| _version_ | 1818341991810859008 |
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| author | Ricardo Sobhie Diaz Maria Cecilia A. Sucupira Tania R.C. Vergara Carlos Brites Rosana Del Bianco Francisco Bonasser Filho Geova Keny B. Colares Estevão Portela Lia Adler Cherman Nemora Tregnago Barcelos Unai Tupinambas Gilberto Turcato, Jr. Lisa Allamasey Lee Bacheler Martin Tuohy |
| author_facet | Ricardo Sobhie Diaz Maria Cecilia A. Sucupira Tania R.C. Vergara Carlos Brites Rosana Del Bianco Francisco Bonasser Filho Geova Keny B. Colares Estevão Portela Lia Adler Cherman Nemora Tregnago Barcelos Unai Tupinambas Gilberto Turcato, Jr. Lisa Allamasey Lee Bacheler Martin Tuohy |
| author_sort | Ricardo Sobhie Diaz |
| collection | DOAJ |
| description | Objective: To investigates how the use of HIV-1 resistance tests influences physician decision-making. Methods: Ten experienced reference physicians from the Brazilian Network for Drug Resistance each received ten patients’ case histories. The selected patients had experienced at least two virological failures. First, reference physicians were asked to empirically select a new regimen for each patient. Second, after genotype report (ViroSeq 2.6) was provided, and physicians were again asked to select a new regimen considering this additional information. Finally, they were asked to select a regimen after receiving a virtual phenotype result (vircoTYPE 3.9.00). Results: In 79% of the cases, physicians changed their empirical choice of regimen after receiving the genotype report, resulting in an increase in the mean number of active drugs from 1.8 to 2.2 (p = 0.0003), while the average number of drugs/regimen remained at 4.0. After receipt of the virtual phenotype report, additional changes were made in 75% of the patient cases, resulting in an increase in the number of active drugs to 2.8 (p < 0.0001), while the average number of drugs/ regimen remained at 4.0. After receipt of the genotype report, 48% of the changes were in NRTIs, 29% were in NNRTIs and 60% were in PIs; after consideration of the virtual phenotype, 61%, 10% and 49% of the changes, respectively, were in these categories of drugs. Fourteen percent of the physicians rated the genotype report as “extremely useful”, whereas 34% rated the subsequent virtual phenotype report as “extremely useful” (p = 0.0003). Conclusions: Resistance testing has a significant impact on physicians’ choices of antiretroviral salvage therapies, and it promotes the selection of more active drugs. Keywords: genotype, virtual phenotype, antiretroviral resistance, Brazil |
| first_indexed | 2024-12-13T16:07:36Z |
| format | Article |
| id | doaj.art-24063d4a7819499a99aeb87568c94c9e |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-12-13T16:07:36Z |
| publishDate | 2010-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-24063d4a7819499a99aeb87568c94c9e2022-12-21T23:39:00ZengElsevierBrazilian Journal of Infectious Diseases1413-86702010-09-01145489494HIV-1 resistance testing influences treatment decision-makingRicardo Sobhie Diaz0Maria Cecilia A. Sucupira1Tania R.C. Vergara2Carlos Brites3Rosana Del Bianco4Francisco Bonasser Filho5Geova Keny B. Colares6Estevão Portela7Lia Adler Cherman8Nemora Tregnago Barcelos9Unai Tupinambas10Gilberto Turcato, Jr.11Lisa Allamasey12Lee Bacheler13Martin Tuohy14Universidade Federal de São Paulo, São Paulo, Brazil; Correspondence to: Retrovirology Laboratory, Universidade Federal de São Paulo - EPM, R. Pedro de Toledo, 781, Sao Paulo, SP - 04039 - Brazil Phone: +55-110-9109-0445, Phone/fax: +55-11-5579- 8226, +55-11-5571-2130, +55-11-5084-4262.Universidade Federal de São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilUniversidade Federal de Bahia, BrazilHospital Emilio Ribas, São Paulo, SP, BrazilHospital Emilio Ribas, São Paulo, SP, BrazilUniversidade de Fortaleza, CE, BrazilFundação Oswaldo Cruz, RJ, BrazilNetwork Reference Physicians Working GroupSecretaria Estadual de Saúde do Rio Grande do Sul, RS, BrazilUniversidade Federal de Minas Gerais, MG, BrasilUniversidade Federal de São Paulo, São Paulo, BrazilVirco BVBA, Mechelen, BelgiumVircoLab Inc, Durham, NC, USAVirco BVBA, Mechelen, BelgiumObjective: To investigates how the use of HIV-1 resistance tests influences physician decision-making. Methods: Ten experienced reference physicians from the Brazilian Network for Drug Resistance each received ten patients’ case histories. The selected patients had experienced at least two virological failures. First, reference physicians were asked to empirically select a new regimen for each patient. Second, after genotype report (ViroSeq 2.6) was provided, and physicians were again asked to select a new regimen considering this additional information. Finally, they were asked to select a regimen after receiving a virtual phenotype result (vircoTYPE 3.9.00). Results: In 79% of the cases, physicians changed their empirical choice of regimen after receiving the genotype report, resulting in an increase in the mean number of active drugs from 1.8 to 2.2 (p = 0.0003), while the average number of drugs/regimen remained at 4.0. After receipt of the virtual phenotype report, additional changes were made in 75% of the patient cases, resulting in an increase in the number of active drugs to 2.8 (p < 0.0001), while the average number of drugs/ regimen remained at 4.0. After receipt of the genotype report, 48% of the changes were in NRTIs, 29% were in NNRTIs and 60% were in PIs; after consideration of the virtual phenotype, 61%, 10% and 49% of the changes, respectively, were in these categories of drugs. Fourteen percent of the physicians rated the genotype report as “extremely useful”, whereas 34% rated the subsequent virtual phenotype report as “extremely useful” (p = 0.0003). Conclusions: Resistance testing has a significant impact on physicians’ choices of antiretroviral salvage therapies, and it promotes the selection of more active drugs. Keywords: genotype, virtual phenotype, antiretroviral resistance, Brazilhttp://www.sciencedirect.com/science/article/pii/S1413867010700982 |
| spellingShingle | Ricardo Sobhie Diaz Maria Cecilia A. Sucupira Tania R.C. Vergara Carlos Brites Rosana Del Bianco Francisco Bonasser Filho Geova Keny B. Colares Estevão Portela Lia Adler Cherman Nemora Tregnago Barcelos Unai Tupinambas Gilberto Turcato, Jr. Lisa Allamasey Lee Bacheler Martin Tuohy HIV-1 resistance testing influences treatment decision-making Brazilian Journal of Infectious Diseases |
| title | HIV-1 resistance testing influences treatment decision-making |
| title_full | HIV-1 resistance testing influences treatment decision-making |
| title_fullStr | HIV-1 resistance testing influences treatment decision-making |
| title_full_unstemmed | HIV-1 resistance testing influences treatment decision-making |
| title_short | HIV-1 resistance testing influences treatment decision-making |
| title_sort | hiv 1 resistance testing influences treatment decision making |
| url | http://www.sciencedirect.com/science/article/pii/S1413867010700982 |
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