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Replication capacity
Sep 9, 2004

What exactly is meant by replication capacity and how can this be tested? Has this become an important part of HIV care??? Can you explain. I have been infected with HIV for 15 years and this is the first I heard of this.

Response from Dr. Pierone

Replication capacity is a measure of how efficiently HIV can grow (or replicate) in experimental conditions. There are a several methods of testing for this viral attribute, but the most common means is through a resistance test called Phenosense GT, commercially available from Virologic.

When viral resistance develops to antiretroviral agents, the replication capacity of this resistant virus often declines. This is the only good thing about viral resistance. The most appropriate role for replication capacity is not yet known. For patients that do not have drug resistance and have undetectable viral load on therapy the test is not relevant. The main way that I use replication capacity is to reassure me if I have made a decision to continue a patient on a regimen that is showing viral breakthrough, but with stable CD4 counts. In a case like this a replication capacity of 3 percent lends support to my clinical suspicion that this is a significantly weakened virus. Ongoing studies should clarify the larger role of this testing in clinical practice and at this point it is not an essential test, but it is definitely a very interesting one.



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