Navigation Links
Drug resistance testing in treatment-naive HIV patients is cost-effective

Testing for drug resistance in HIV-infected patients at the time of HIV diagnosis is cost-effective and may increase patients' life expectancy, according to an article in the Nov. 1 issue of Clinical Infectious Diseases, now available online.

Resistance to antiretroviral therapy, even in patients who have never received treatment, is a growing concern. However, genotype resistance testing, which involves looking for the presence of resistance genes, is not a standard procedure at the time a patient is diagnosed with HIV, probably due to lack of data on its benefits and its relatively high cost compared with other routine blood tests.

A cost-effectiveness analysis conducted by a group of Boston researchers indicates that performing genotype resistance testing at initial HIV diagnosis--before treatment is started--can effectively guide a physician's choice of treatment regimen and increase a patient's quality-adjusted life expectancy. (Quality-adjusted measurements of time reflect that survival with an illness is presumed to be of lower quality than healthy survival.)

"For the approximately 90 percent of patients with no resistance, the testing provides no benefit," said lead author Paul Sax, MD, of Brigham and Women's Hospital. "However, if certain types of resistance are present [when a patient is first diagnosed with HIV], our study projects a substantial increase in survival" of more than 14 months, compared with no resistance testing.

Resistance rates vary from place to place. It is estimated that, in the United States and Europe, the average resistance rate in treatment-naive patients is between 8 and 10 percent, although baseline resistance may be as high as 16 percent in gay men, "likely reflecting their overall greater access to treatment since the beginning of the epidemic," said Dr. Sax. Using a model with a resistance rate of just over 8 percent, the analysis estimated a cost of $23,900 per quality-adjusted life year gain ed, which is within the range of other commonly accepted HIV interventions. The cost-effectiveness calculation remained below $50,000 per quality-adjusted year gained unless the resistance rate was 1 percent or less, which is much lower than in most areas.

An accompanying editorial commentary by Frederick Hecht, MD, and Robert Grant, MD, of the University of California, San Francisco, agrees that "there is now sufficiently strong information to recommend genotypic resistance testing in all drug na�ve patients at the time of diagnosis." However, the authors, who have received support from various pharmaceutical and diagnostic companies, caution that there are some drug resistance mutations that may not be detectable by standard resistance tests.

The cost of performing the one-time test--now about $400--has decreased from when it was first approved, and will likely continue to drop. Some physicians are not yet convinced of the value of genotype resistance testing, and some insurance companies do not yet cover it, but the practice of resistance testing at initial HIV diagnosis has gradually increased. "We're hoping that this study makes it part of standard care," said Dr. Sax.


'"/>

Source:Infectious Diseases Society of America


Related biology news :

1. Study identifies predictors of HIV drug resistance in patients beginning triple therapy
2. Researchers make gains in understanding antibiotic resistance
3. MUHC scientists describe genetic resistance to rampant virus
4. New polysaccharide may help combat multidrug resistance in cancer
5. New book explains antibiotic resistance for a broad audience
6. Insects develop resistance to engineered crops
7. Retroviral resistance gene found
8. Researchers use RNAi libraries to identify regulators of apoptosis and chemoresistance
9. Gaining ground in the race against antibiotic resistance
10. Genes linked to treatment resistance in children with leukemia
11. Einstein researchers identify new way that bacteria develop resistance to antibiotics
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:4/13/2017)... , April 13, 2017 According to a ... Identity Authentication, Identity Analytics, Identity Administration, and Authorization), Service, Authentication Type, Deployment ... the IAM Market is expected to grow from USD 14.30 Billion in ... Rate (CAGR) of 17.3%. ... MarketsandMarkets Logo ...
(Date:4/6/2017)... Forecasts by Product Type (EAC), ... End-Use (Transportation & Logistics, Government & Public Sector, Utilities ... Generation Facility, Nuclear Power), Industrial, Retail, Business Organisation (BFSI), ... you looking for a definitive report on the $27.9bn ... ...
(Date:4/3/2017)... 3, 2017  Data captured by IsoCode, ... detected a statistically significant association between the ... treatment and objective response of cancer patients ... predict whether cancer patients will respond to ... well as to improve both pre-infusion potency testing ...
Breaking Biology News(10 mins):
(Date:10/12/2017)... FL (PRWEB) , ... October ... ... (RPS®) today announces publication of a United States multicenter, prospective clinical study ... use, disposable, point-of-care diagnostic test capable of identifying clinically significant acute bacterial ...
(Date:10/11/2017)... ... October 11, 2017 , ... At ... Purple announced Dr. Suneel I. Sheikh, the co-founder, CEO and chief research scientist ... has been selected for membership in ARCS Alumni Hall of Fame . ...
(Date:10/11/2017)... ... October 11, 2017 , ... Proscia Inc ., ... a Webinar titled, “Pathology is going digital. Is your lab ready?” with Dr. ... best practices and how Proscia improves lab economics and realizes an increase in ...
(Date:10/11/2017)... ... October 11, 2017 , ... A new study ... in frozen and fresh in vitro fertilization (IVF) transfer cycles. The ... IVF success. , After comparing the results from the fresh and frozen transfer ...
Breaking Biology Technology: