Laboratory Testing For Hiv Tropism

HIV tropism testing can determine the predominant coreceptor protein used by HIV to infect target cells. Tropism testing can help select patients for treatment with HIV coreceptor antagonists (eg, maraviroc), which block specific coreceptor proteins. For individuals who have HIV infection who are being considered for HIV coreceptor antagonist therapy who receive HIV tropism testing, the evidence includes randomized controlled trials (RCTs). Relevant outcomes are overall survival, disease-specific survival, morbid events, quality of life, hospitalizations, medication use, and treatment-related morbidity. RCTs on treatment-naive and treatment-experienced HIV-infected patients have provided evidence that selection of candidates for HIV coreceptor antagonist therapy using HIV tropism testing results in higher rates of treatment success compared with HIV coreceptor antagonist therapy without HIV tropism testing. The evidence is sufficient to determine that the technology results in a meaningful improvement in the net health outcome. For individuals with HIV infection receiving HIV coreceptor antagonist therapy or who have failed coreceptor antagonist therapy who receive HIV tropism testing, the evidence includes post hoc analysis of RCTs and observational studies. Relevant outcomes are overall survival, disease-specific survival, morbid events, quality of life, hospitalizations, medication use, and treatment-related mortality and morbidity. Current evidence does not indicate improved outcomes with additional tropism monitoring during treatment. The evidence is insufficient to determine the effects of the technology on health outcomes. For individuals with HIV infection who are undergoing tests to predict disease progression who receive HIV tropism testing, the evidence includes observational studies. Relevant outcomes are overall survival, disease-specific survival, morbid events, quality of life, hospitalizations, and medication use. Current evidence is inconsistent in as relates to whether HIV tropism testing independently predicts disease progression among HIV-infected patients. The evidence is insufficient to determine the effects of the technology on health outcomes <a id="