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Prospective
Trials of Drug Resistance Testing
HAVANA
A study that addresses directly the role of expert advice is the
Havana study, conducted in Spain. This randomized study compared
the utility of genotypic resistance testing, expert advice, or both
as compared to standard of care in selecting salvage regimens for
patients experiencing failure of antiretroviral therapy (plasma
HIV-1 RNA level >1000 copies/mL).
Two hundred forty-seven patients were enrolled. Genotyping and expert
advice each resulted in significantly better virologic response.
The best response rates were observed in patients who received both
genotyping and expert advice. These results suggest that although
expert advice is helpful, the availability of genotypic resistance
assays leads to further improvements in virologic outcome of salvage
therapy (21).
4/15/01
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