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Current treatment guidelines recommend HIV genotypic resistance testing before antiretroviral therapy (ART) is initiated (JW AIDS Clin Care Dec 10 2007). However, the most common type of testing, consensus sequencing of serum samples, may underestimate rates of transmitted resistance.
In a publicly funded study, researchers tested 104 newly diagnosed, ART-naive HIV-positive people in Seattle using a sensitive oligonucleotide ligation assay (OLA) that measures HIV-derived DNA in peripheral blood mononuclear cells. The OLA’s detection of protease and reverse-transcriptase resistance mutations at 15 codons was compared with that of standard serum genotyping.
Resistance mutations were detected significantly more often by OLA (33 mutations in 18 p…