HIV Test May Show Which Drugs Work Best

An experimental HIV drug-resistance test can detect even very small amounts of resistant HIV strains, ones that could eventually cause treatment complications or failure, a new study suggests. Such a test could help physicians predict the best treatment option from the outset, reduce treatment costs, and potentially curb a patient's infectiousness.

Current analyses are able to detect resistant strains only if they represent a significant proportion circulating in the patient's blood.

Dr. Feng Gao and Duke University colleagues helped to develop the test and publish proof of its accuracy and sensitivity. Duke is currently seeking to patent and, ultimately, market the test. But the test still needs proof it positively affects treatment outcomes.

"A lot of questions are still unanswered, but it's an important step forward," said Dr. Peter Leone, a physician at University of North Carolina-Chapel Hill and medical director of the state's HIV prevention branch. If successful, a more sensitive resistance test could "improve the odds that the first course of treatment is going to be successful," he said.

The documentation of drug-resistant HIV strains infecting treatment-naive patients has garnered federal government support for making routine viral-resistance testing a standard of care. The government's recommendation, effective last year, means most private and public health insurers will cover resistance testing. The tests can cost from several hundred dollars to $1,000 or more.

The full report, "Detection of Minor Drug-Resistant Populations by Parallel Allele-Specific Sequencing," was published in the advance online Nature Methods (2007;doi:10.1038/nmeth995).

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