%0 Journal Article
%T Comparison of predicted susceptibility between genotype and virtual phenotype HIV drug resistance interpretation systems among treatment-naive HIV-infected patients in Asia: TASER-M cohort analysis
%A Awachana Jiamsakul
%A Rami Kantor
%A Patrick CK Li
%A Sunee Sirivichayakul
%A Thira Sirisanthana
%A Pacharee Kantipong
%A Christopher KC Lee
%A Adeeba Kamarulzaman
%A Winai Ratanasuwan
%A Rossana Ditangco
%A Thida Singtoroj
%A Somnuek Sungkanuparph
%A On behalf of the TREAT Asia Studies to Evaluate Resistance ¨C Monitoring Study (TASER-M)
%J BMC Research Notes
%D 2012
%I BioMed Central
%R 10.1186/1756-0500-5-582
%X Sequences from 1301 ARV-naive patients enrolled in the TREAT Asia Studies to Evaluate Resistance ¨C Monitoring Study (TASER-M) were analysed by both interpreting systems. Interpretations from both Stanford HIVdb and vircoTYPE£¿ HIV-1 were initially grouped into 2 levels: susceptible and non-susceptible. Discrepancy was defined as a discordant result between the susceptible and non-susceptible interpretations from the two systems for the same ARV. Further analysis was performed when interpretations from both systems were categorised into 3 levels: susceptible, intermediate and resistant; whereby discrepancies could be categorised as major discrepancies and minor discrepancies. Major discrepancy was defined as having a susceptible result from one system and resistant from the other. Minor discrepancy corresponded to having an intermediate interpretation in one system, with a susceptible or resistant result in the other. The level of agreement was analysed using the prevalence adjusted bias adjusted kappa (PABAK).Overall, the agreement was high, with each ARV being in ¡°almost perfect agreement¡±, using Landis and Koch¡¯s categorisation. Highest discordance was observed for efavirenz (75/1301, 5.8%), all arising from susceptible Stanford HIVdb versus non-susceptible vircoTYPE£¿ HIV-1 predictions. Protease Inhibitors had highest level of concordance with PABAKs all above 0.99, followed by Nucleoside Reverse Transcriptase Inhibitors with PABAKs above 0.97 and non-NRTIs with the lowest PABAK of 0.88. The 68/75 patients with discordant efavirenz results harboured the V179D/E mutations compared to 7/1226 with no efavirenz discrepancy (p-value <0.001). In the 3-level comparison, all but one of the discrepancies was minor.The two systems agreed well with lowest concordance observed for efavirenz. When interpreting HIVDR, especially in non-B subtypes, clinical correlation is crucial, in particular when efavirenz resistance is interpreted based on V179D/E.In recent years, developing
%K Asia
%K HIV
%K Resistance
%K Interpretation
%K Algorithm
%U http://www.biomedcentral.com/1756-0500/5/582