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Comment & Response
November 27, 2018

Baseline Genotype Testing to Assess Drug Resistance Before Beginning HIV Treatment

Author Affiliations
  • 1Infectious Diseases Service, Hospital Clinic of Barcelona, Barcelona, Spain
  • 2Service of Microbiology, Hospital Clinic of Barcelona, Barcelona, Spain
JAMA. 2018;320(20):2153-2154. doi:10.1001/jama.2018.15926

To the Editor In the updated Recommendations of the International Antiviral Society–USA Panel for the treatment and prevention of human immunodeficiency virus (HIV) infection in adults,1 the recommendations for laboratory monitoring have been revised to include the use of baseline HIV genotype to assess transmitted drug resistance. The panel recommended testing only for nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, and protease inhibitors, and reserved testing for integrase strand-transfer inhibitor (InSTI) resistance to cases of suspected exposure to a partner with InSTI resistance. All preferred regimens are InSTI-based, favoring dolutegravir and bictegravir and, when those are not available, raltegravir and elvitegravir/cobicistat.1