Resistance testing seems to be currently limited to demonstrated failures under a specific multi-drug therapeutic regimen (HAART). What percentage of the HIV patients (in the United States) receiving treatment fall into this category? I would imagine that all of these patients should get resistance testing. What percent do you think actually get testing and why is it less than 100%? If the shortfall is an educational or awareness issue, how long do you think it will take to get that number to 50 or 75%? —Mark Majkowski, DDS
Dr. Brian Conway responds: As many as 50% patients experience virologic breakthrough on HAART therapy each year, and an increasing number of such patients would be gaining access to resistance testing. This is especially true in light of the recent publication of the IAS-USA guidelines in JAMA supporting this as a major application of resistance testing in clinical practice. As reimbursement issues become addressed and as increasing numbers of physicians become more comfortable with the process of ordering the test and interpreting its results, the majority of patients would be tested on a routine basis. (8/1/2000)
