More Evidence That Transmitted Resistance Does Matter — An Analysis from ACTG 5095

Treatment guidelines from the U.S. Department of Health and Human Services now recommend HIV genotypic resistance testing prior to the initiation of antiretroviral therapy (ACC Dec 10 2007). Although these recommendations seem sound and are based on data demonstrating considerable levels of transmitted resistance, little is known about the influence of such resistance on virologic suppression and treatment outcomes. In this case-cohort analysis from ACTG 5095, investigators performed genotypic resistance testing on baseline plasma samples and examined the effect of transmitted NNRTI resistance on treatment outcomes among treatment-naive patients who were randomized to efavirenz-containing regimens.

Overall, 5% of patients had transmitted NNR…