Aug 7, 2002
I am hearing this term more amd more and I was wondering if any tests are being developed for the general public?It seems since hiv is SO indivdualized no two viral loads neccesarily mean the same thing and this would be a great way to see how "strong" someones strain actually is?what's your opinion? Thank you
Response from Dr. Wohl
The question of how measurements of so called viral fitness will fit in to clinical practice is a good one. First, let's make sure we all understand what we are talking about. Viral fitness is used to describe how well an HIV isolate can replicate. There is good eveidence that virus that accumulates antiretroviral resistance mutations is less fit (i.e. has a harder time replicating and harming immune cells). This makes some sense as to survive the onslaught of HIV meds the virus has to do some major contortions. The result is the virus can still make more of itself in the presence of drug but has a harder time doing it.
Viral fitness is typically measured in a laboratory setting where the replication capacity of a patient's virus is examined in the absence of HIV medications and compared to a laboratory strain of virus that is considered 'wild type' (no mutations). This is now becoming available commercially in combination with genotype an phenotype tests.
Although this is sleek stuff, there really is not a whole lot of data yet that indicates making treatment decisions based on these viral fitness assays is good, bad or indifferent. However, I think we will hear and see more about creative applications of this technology in the future. Meanwhile, I think the paradigm of high virus bad, low virus good holds no matter how many push-ups your virus can do. Good question, thanks-DW
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