Sep 6, 2001
I'm about to start treatment due to my high viral load=400k and low cd4=200 and i would like to take up a clinical trial. I kindly requested a resistance test but i was refused due to insufficient funds. My question is whether i am entitled of a resistance test or can i pay for it and how much is it? Thanks
Response from Dr. Little
This is a difficult situation. Current standards of care do not yet support the use of routine drug resistance testing in patients about to initiate antiretroviral therapy. Having said this, I suspect that this will change within the next year or so, but insurance carriers are not yet aware of the changing momentum within the field and will rarely provide this kind of coverage at the present time. If you are interested in a clinical trial, then I would discuss this with the local trial centers - many studies today offer/require drug resistance testing prior to study entry.
Given the information that I have seen presented recently, I would consider purchasing this test out of pocket (if this is not too great a hardship) or asking about compassionate access testing (the ViroLogic.com website addresses this issue). The cost of genotype testing is about $250-$450 and the cost of phenotype testing may be closer to $600. These costs are only very rough estimates, and real costs may vary substantially depending on your location.
I would talk to your doctor about which test he/she is most familiar with and what options might exist for you to purchase or arrange one of them (both give excellent and slightly different information). If the test shows the presence of drug resistance to one or more drugs, it will be completely worth the cost in that you and your doctor can use this information to choose the best regimen for you in the face of pre-existing drug resistance.
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