HIV-1 resistance testing influences treatment decision-making
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Brazilian Journal of Infectious Diseases |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702010000500011 |
Resumo: | 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 |
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Brazilian Journal of Infectious Diseases |
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HIV-1 resistance testing influences treatment decision-makinggenotypevirtual phenotypeantiretroviral resistanceBrazilOBJECTIVE: 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 drugsBrazilian Society of Infectious Diseases2010-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702010000500011Brazilian Journal of Infectious Diseases v.14 n.5 2010reponame:Brazilian Journal of Infectious Diseasesinstname:Brazilian Society of Infectious Diseases (BSID)instacron:BSID10.1590/S1413-86702010000500011info:eu-repo/semantics/openAccessDiaz,Ricardo SobhieSucupira,Maria Cecilia AVergara,Tania RCBrites,CarlosBianco,Rosana DelBonasser Filho,FranciscoColares,Geova Keny BPortela,EstevãoCherman,Lia AdlerBarcelos,Nemora TregnagoTupinambas,UnaiTurcato Jr,GilbertoAllamasey,LisaBacheler,LeeTuohy,Martineng2011-01-03T00:00:00Zoai:scielo:S1413-86702010000500011Revistahttps://www.bjid.org.br/https://old.scielo.br/oai/scielo-oai.phpbjid@bjid.org.br||lgoldani@ufrgs.br1678-43911413-8670opendoar:2011-01-03T00:00Brazilian Journal of Infectious Diseases - Brazilian Society of Infectious Diseases (BSID)false |
dc.title.none.fl_str_mv |
HIV-1 resistance testing influences treatment decision-making |
title |
HIV-1 resistance testing influences treatment decision-making |
spellingShingle |
HIV-1 resistance testing influences treatment decision-making Diaz,Ricardo Sobhie genotype virtual phenotype antiretroviral resistance Brazil |
title_short |
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_sort |
HIV-1 resistance testing influences treatment decision-making |
author |
Diaz,Ricardo Sobhie |
author_facet |
Diaz,Ricardo Sobhie Sucupira,Maria Cecilia A Vergara,Tania RC Brites,Carlos Bianco,Rosana Del Bonasser Filho,Francisco Colares,Geova Keny B Portela,Estevão Cherman,Lia Adler Barcelos,Nemora Tregnago Tupinambas,Unai Turcato Jr,Gilberto Allamasey,Lisa Bacheler,Lee Tuohy,Martin |
author_role |
author |
author2 |
Sucupira,Maria Cecilia A Vergara,Tania RC Brites,Carlos Bianco,Rosana Del Bonasser Filho,Francisco Colares,Geova Keny B Portela,Estevão Cherman,Lia Adler Barcelos,Nemora Tregnago Tupinambas,Unai Turcato Jr,Gilberto Allamasey,Lisa Bacheler,Lee Tuohy,Martin |
author2_role |
author author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Diaz,Ricardo Sobhie Sucupira,Maria Cecilia A Vergara,Tania RC Brites,Carlos Bianco,Rosana Del Bonasser Filho,Francisco Colares,Geova Keny B Portela,Estevão Cherman,Lia Adler Barcelos,Nemora Tregnago Tupinambas,Unai Turcato Jr,Gilberto Allamasey,Lisa Bacheler,Lee Tuohy,Martin |
dc.subject.por.fl_str_mv |
genotype virtual phenotype antiretroviral resistance Brazil |
topic |
genotype virtual phenotype antiretroviral resistance Brazil |
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 |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702010000500011 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702010000500011 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1413-86702010000500011 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Brazilian Society of Infectious Diseases |
publisher.none.fl_str_mv |
Brazilian Society of Infectious Diseases |
dc.source.none.fl_str_mv |
Brazilian Journal of Infectious Diseases v.14 n.5 2010 reponame:Brazilian Journal of Infectious Diseases instname:Brazilian Society of Infectious Diseases (BSID) instacron:BSID |
instname_str |
Brazilian Society of Infectious Diseases (BSID) |
instacron_str |
BSID |
institution |
BSID |
reponame_str |
Brazilian Journal of Infectious Diseases |
collection |
Brazilian Journal of Infectious Diseases |
repository.name.fl_str_mv |
Brazilian Journal of Infectious Diseases - Brazilian Society of Infectious Diseases (BSID) |
repository.mail.fl_str_mv |
bjid@bjid.org.br||lgoldani@ufrgs.br |
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1754209241492619264 |