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HIV Drug ResistanceHIV Drug Resistance
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line probe assay
Jun 6, 2001

Dear Dr., I heard mentioned that a lineprobe assay is a resistance test that can be sued when vl<1,000 copies. Is this true? Is it a genotype or phenotype test? And are any commercial labs running this test? How can I get it done?Secondly,I've heard that you can send your blood to a univ to see how virulent a strain you have.Is this a good idea?and how do you do this?Sincerely,Luke

Response from Dr. Little

The line probe assay can be done with relatively low levels of virus, but at present is less clinically useful than the available genotype and phenotype tests because it only detects drug resistance mutations in one class of drugs (the nucleosides - AZT,ddI,3TC,d4T,ABC, ddC). Although the makers of the line probe are working on modifications which would detect all of the well described drug resistance mutations, I would guess that the most useful test for use in management of your antiretrovirals would still be a genotype or phenotype. Some of the commercially available genotype and phenotype tests can now be used down to a viral load close to 200 copies. I would discuss the need for such a test and perhaps even find out from the laboratory what their lower limit is for submitting a specimen (in terms of the viral load) and then order whichever test seems like it will most likely give you an answer.

In terms of determining whether you have a virulent strain - there are many tests available on a research basis which do address this sort of thing, but they are generally not used in clinical practice, because they do not change treatment management. If you are interested in contributing to the field of research, you may have local opportunities worth pursuing, but I would not advise that you seek out this test otherwise, since it is not clear that it would be particularly helpful. The rate at which your T cells fall or remain stable over time will give you the same information.

Food for thought...mild HIV ?

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