6533b829fe1ef96bd128a5e9
RESEARCH PRODUCT
Rules-based HIV-1 genotypic resistance interpretation systems predict 8 week and 24 week virological antiretroviral treatment outcome and benefit from drug potency weighting
M ZazziM ProsperiI VicentiS Di GiambenedettoA CallegaroB BruzzoneF BaldantiA GonnelliE BoeriE PaoliniS RusconiA GiacomettiF MaggioloS MenzoA De Luca Arca Collaborative GroupA GiacomettiL ButiniR Del GobboS MenzoD TacconiG CorbelliS ZanussiL MonnoG PunziF MaggioloA CallegaroL CalzaMc ReR PristeràP TurconiA MandasS TiniG CarnevaleE PaoliniG AmadioL SighinolfiG ZuccatiM MorfiniR ManettiP CorsiL GalliM Di PietroF BartalesiG ColaoA TostiA Di BiagioM SettiB BruzzoneG PencoM TrezziA OraniR PardelliM De GennaroA ChioderaA ScalziniL PalvariniP AlmiG TodaroP CicconiS RusconiMr GismondoMr GismondoV MicheliMl BiondiN GianottiA CapettiP MeravigliaE BoeriC MussiniM PecorariM SantirocchiD BrustiaP RavaniniF Dal BelloN RomanoS MancusoC CalzettiR MaseratiG FiliceF BaldantiD FrancisciG ParrutiE PolilliD SacchiniC MartinelliRita Consolinisubject
Maleinterpretation systemHIV InfectionsDrug resistanceLogistic regressionRetrospective StudieHIV InfectionPharmacology (medical)Microbial Sensitivity TestMiddle AgedPrognosisgenotype drug resistance algorithmAlgorithmTreatment OutcomeInfectious DiseasesItalyRNA ViralFemaleCohort studyHumanMicrobiology (medical)Adultmedicine.medical_specialtyGenotypeLogistic ModelAnti-HIV AgentsPrognosiantiretroviralMicrobial Sensitivity TestsInternal medicinemedicinePotencyAnimalsHumansRetrospective StudiesPharmacologyReceiver operating characteristicbusiness.industryAnimalAnti-HIV AgentRetrospective cohort studyOdds ratiogenotype; interpretation system; antiretroviral; drug potency weightingWeightingLogistic ModelsROC CurveDrug resistanceImmunologyHIV-1businessdrug potency weightingdescription
Objectives: To test retrospectively the ability of four freely available rules-based expert systems to predict short- and medium-term virological outcome following an antiretroviral treatment switch in pre-treated HIV-1 patients. Methods: The HIV-1 genotype interpretation systems (GISs) HIVdb, ANRS, Rega and AntiRetroScan were tested for their accuracy in predicting response to highly active antiretroviral therapy using 8 week (n = 765) and 24 week (n = 634) follow-up standardized treatment change episodes extracted from the Italian Antiretroviral Resistance Cohort Analysis (ARCA) database. A genotypic sensitivity score (GSS) was derived for each genotype-treatment pair for the different GISs and tested as a predictor of virological treatment outcome by univariable and multivariable logistic regression as well as by receiver operating characteristic curve analysis. The two systems implementing drug potency weights (AntiRetroScan and Rega) were evaluated with and without this correction factor. Results: All four GSSs were strong predictors of virological treatment outcome at both 8 and 24 weeks after adjusting for baseline viro-immunological parameters and previous drug exposure (odds ratios ranging from 2.04 to 2.43 per 1 unit GSS increase; P < 0.001 for all the systems). The accuracy of AntiRetroScan and Rega was significantly increased by drug potency weighting with respect to the unweighted versions (P ≤ 0.001). HIVdb and ANRS also increased their performance with the same drug potency weighting adopted by AntiRetroScan and Rega, respectively (P < 0.001 for both analyses). Conclusions: Currently available GISs are valuable tools for assisting antiretroviral treatment choices. Drug potency weighting can increase the accuracy of all systems. © The Author 2009. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2009-01-01 |