Reports from resistance-related conferences and courses.
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| HIVresistanceWeb Roundtable 2000: HIV Drug Resistance Testing |
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Question
1 |
Welcome to
HIVresistanceWeb's second annual Roundtable on HIV Drug Resistance Testing.
This Roundtable discussion was held to address key questions pertaining
to the current status, development, and future utility of genotypic and
phenotypic drug resistance assays in the clinical management of HIV infection.
Roundtable Participants:
Charles Boucher, M.D., Ph.D.
Department of Medical Microbiology
Utrecht University
Brian Conway, M.D.
Department of Pharmacology & Therapeutics
University of British Columbia
Douglas Mayers, M.D.
Division of Infectious Diseases
Henry Ford Hospital
David A. Katzenstein, M.D.
Center for AIDS Research
Stanford University
Michelle E. Roland, M.D.
Department of Medicine
UCSF AIDS Program
Jonathan M. Schapiro, M.D.
Director, AIDS Service
National Hemophilia Center
Tel Hashomer, Israel
Robert W. Shafer, M.D.
Center for AIDS Research
Stanford University Medical Center
Mark A. Wainberg, Ph.D.
McGill AIDS Centre
Jewish General Hospital
Montreal, Quebec
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What is the evidence that phenotyping
is a better guide to therapy than genotyping in the expert interpretation
of resistance test results? |
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Question
2 |
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What is the role or the responsibility
of the laboratory performing genotypic or phenotypic assays with respect
to interpretation of results? |
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Question
3 |
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Do you think we'll ever get to a state
in which perfect algorithms will allow us to deduce a 'virtual clinical
outcome' on the basis of genotypic and phenotypic data? |
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Question
4 |
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If you have both in vitro and in vivo
data pertaining to the resistance profile of a given drug, which is more
important? |
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Question
5 |
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What is the status of thymidine-associated
mutations with regard to AZT vs. d4T? |
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Question
6 |
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With respect to M184V and K103N, should
physicians be trying to maintain these "beneficial" mutations? |
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Question
7 |
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Have viruses with stable, non-reverting
mutations somehow compensated for their presence and should we treat these
patients and their isolates differently? |
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Question
8 |
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What is the level of phenotypic resistance
that is clinically significant for individual drugs? |
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Question
9 |
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What do each of you think
of the relative value of genotypic/phenotypic assays with respect to assay
sensitivity, turn around time, expense, and ease of interpretation for a
clinician? |
