Dr. Brian Conway responds: Overall, current recommendations support the use of resistance testing for the selection of initial antiretroviral therapy only in settings where the prevalence of primary drug resistance is known to be high (say, 10% or more), as demonstrated in population-based surveys. However, if sub-optimal virologic suppression is achieved in the first few weeks/months of therapy, this should prompt a request for resistance testing to investigate the cause of the poor response. (8/1/2000)
Return to Ask the Experts Home PageIf resistance testing gives insight into the best drugs to use as therapeutic agents, why isn't it the first step to get the treatment off with the best drug combination? The total cost of annual therapy is very high, even without complications. Isn't the up front expenditure worthwhile to make sure the resources are properly applied? Do you think there are circumstances where resistance testing will be an ordinary first course of all HIV treatment? How long do you think it will take for this to occur? —Mark Majkowski, DDS
