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HIV Drug ResistanceHIV Drug Resistance
          
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Testing before treatment
Mar 22, 2001

Dr. Little,

thanks so much for this great service. I was recently diagnosed with HIV and my doctor has not started me on medications yet.

He didn't say anything about doing a resistance test, but in reading through this website it seems like it might be a good idea.

Do you think I need to get one before choosing medications? What kind do you recommend?

thanks - rachel

Response from Dr. Little

Dear Rachel, The indications for resistance testing in newly diagnosed individuals have not been defined. If you are recently infected (that is, you have laboratory tests that indicate you have been infected less than 1 year), I think there is good evidence to support the use of resistance testing regardless of whether immediate therapy is planned. However, if your infection is of greater duration than a year or so, we simply do not know the answer. The test will be quite useful if drug resistance is identified and yet, the absence of identified drug resistance mutations should not be interpreted as a guarentee that no resistant viral variants exist. So, a positive test is useful at all times of infection, a negative test not all that reassuring if there is a long delay between the HIV infection date and resistance testing date. The choice of which test to use is probably best made by determining which assay (genotype or phenotype) your provider is more comfortable interpreting. Both provide useful information, but the interpretation of genotype tests may be more difficult than phenotype test results.


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