Consensus statement of the European guidelines on clinical management of HIV-1 tropism testing


Autoria(s): Vandekerckhove, LPR; Wensing, AMJ; Brun-Vezinet, F; Clotet, B; De Luca, A; Dressler, S; Garcia, F; Geretti, AM; Klimkait, T; Korn, K; Masquelier, B; Perno, CF; Schapiro, J; Soriano, V; Sönnerborg, A; Vandamme, ÀM; Verhofstede, C; Walter, H; Zazzi, M; Boucher, CA
Data(s)

02/08/2012

02/08/2012

08/11/2010

Resumo

Introduction: Testing for HIV tropism is recommended before prescribing a chemokine receptor blocker. To date, in most European countries HIV tropism is determined using a phenotypic test. Recently, new data have emerged supporting the use of a genotypic HIV V3-loop sequence analysis as the basis for tropism determination. The European guidelines group on clinical management of HIV-1 tropism testing was established to make recommendations to clinicians and virologists. Methods: We searched online databases for articles from Jan 2006 until March 2010 with the terms: tropism or CCR5-antagonist or CCR5 antagonist or maraviroc or vicriviroc. Additional articles and/or conference abstracts were identified by hand searching. This strategy identified 712 potential articles and 1240 abstracts. All were reviewed and finally 57 papers and 42 abstracts were included and used by the panel to reach a consensus statement. Results: The panel recommends HIV-tropism testing for the following indications: i) drug-naïve patients in whom toxicity or limited therapeutic options are foreseen; ii) patients experiencing therapy failure whenever a treatment change is considered. Both the phenotypic Enhanced Trofile assay (ESTA) and genotypic population sequencing of the V3-loop are recommended for use in clinical practice. Although the panel does not recommend one methodology over another it is anticipated that genotypic testing will be used more frequently because of its greater accessibility, lower cost and shorter turnaround time. The panel also provides guidance on technical aspects and interpretation issues. If using genotypic methods, triplicate PCR amplification and sequencing testing is advised using the G2P interpretation tool (clonal model) with an FPR of 10%. If the viral load is below the level of reliable amplification, proviral DNA can be used, and the panel recommends performing triplicate testing and use of an FPR of 10%. If genotypic DNA testing is not performed in triplicate the FPR should be increased to 20%. Conclusions: The European guidelines on clinical management of HIV-1 tropism testing provide an overview of current literature, evidence-based recommendations for the clinical use of tropism testing and expert guidance on unresolved issues and current developments. Current data support both the use of genotypic population sequencing and ESTA for co-receptor tropism determination. For practical reasons genotypic population sequencing is the preferred method in Europe.

Tenth International Congress on Drug Therapy in HIV Infection 7-11 November 2010 Glasgow, UK

Identificador

Vandekerckhove L, Wensing A, Kaiser R, Brun-Vezinet F, Clotet B, De Luca a, et al. Consensus statement of the European guidelines on clinical management of HIV-1 tropism testing. J Int AIDS Soc. 2010;13(Suppl 4):O7.

1758-2652 (Online)

PMC3112869

http://hdl.handle.net/10668/440

3112869

10.1186/1758-2652-13-S4-O7

Idioma(s)

en

Publicador

BioMed Central

Relação

Journal of the International AIDS Society

http://www.jiasociety.org/index.php/jias/article/view/17685

Tenth International Congress on Drug Therapy in HIV Infection

7-11 November 2010

Glasgow, UK

Direitos

Acceso abierto

Palavras-Chave #Receptores de Superficie Celular #Reguladores del Crecimiento de las Plantas #VIH #Consensus Development Conferences, NIH as Topic #Quimioterapia #Práctica Clínica Basada en la Evidencia #Receptores de Quimiocina #Pirimidinas #Triazoles #Pruebas de Toxicidad #Infecciones por VIH #Insuficiencia del Tratamiento #Bioensayos #Medical Subject Headings::Organisms::Viruses::DNA Viruses #Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Growth Substances::Plant Growth Regulators #Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::DNA-Binding Proteins::Trans-Activators::Gene Products, tat::tat Gene Products, Human Immunodeficiency Virus #Medical Subject Headings::Health Care::Health Care Economics and Organizations::Organizations::Congresses as Topic::Consensus Development Conferences as Topic::Consensus Development Conferences, NIH as Topic #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy #Medical Subject Headings::Disciplines and Occupations::Health Occupations::Evidence-Based Practice #Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Membrane Proteins::Receptors, Cell Surface::Receptors, G-Protein-Coupled::Receptors, Chemokine #Medical Subject Headings::Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 1-Ring::Pyrimidines #Medical Subject Headings::Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 1-Ring::Piperazines #Medical Subject Headings::Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Alicyclic::Cycloparaffins::Cyclohexanes #Medical Subject Headings::Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 1-Ring::Azoles::Triazoles #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Toxicity Tests #Medical Subject Headings::Diseases::Immune System Diseases::Immunologic Deficiency Syndromes::HIV Infections #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome::Treatment Failure #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Biological Assay #Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Membrane Proteins::Receptors, Cell Surface
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/published

Meeting Abstract