Determining HIV Drug Resistance
- Clinicians should consult with an expert to interpret the results of resistance assays because such results are often complex. (A3)
- The NYSDOH AI Clinical Education Initiative line is available for phone consultation: 866-637-2342.
- When determining the optimal regimen for achieving viral suppression, clinicians should perform genotypic resistance testing that includes the protease (A2), RT (A2), and integrase genes (B2) at baseline, whether ART is being initiated or not.
- In patients experiencing treatment failure [a] or incomplete viral suppression; such testing should be performed while patients are still on therapy, but no later than 4 weeks after stopping ART, given the rapid return of wild-type virus. (A2)
- Perform co-receptor tropism testing prior to initiation of a CCR5 antagonist. (A1)
- If fusion inhibitor resistance is suspected, that test should be obtained as a supplement to the other genotypic resistance tests. (A2)
