An assumption underlying this study was that an undiagnosed population was the most suitable in which to study rates of TDR, as HIV infection was unknown and hence exposure to ART would be unlikely. Nevertheless, the possibility cannot be excluded that individuals knew about their HIV infection, were ART-experienced, and Selleck BIBW2992 did not disclose this at the time of the clinic visit. These data should consequently be interpreted cautiously with respect to rates of TDR in new UK diagnoses. Additionally, the method used for serological incidence profiling
has an appreciable error rate for diagnosing recent HIV infection in an individual. Therefore, patients with nonrecent HIV infection or AIDS may be misclassified as recently infected . For the minority species PCR assays, Natural Product Library molecular weight the sensitivity cut-offs (i.e. the level below which false positives are known to occur) were determined using stored pre-ART era specimens . The 1% sensitivity cut-off applied in this study was equal to or less sensitive than the levels determined using the pre-ART era samples. It is unlikely the increases in minority drug resistance determined in this study are the result of naturally occurring background polymorphisms, but this possibility cannot be entirely excluded. There is growing interest in incorporating more sensitive minority mutation assays into baseline assessments of new diagnoses
for the surveillance of TDR. This study clearly shows that, in this UK HIV-infected population, the three mutation assays did not all confer the same additional benefit in detecting TDR over standard Cediranib (AZD2171) genotypic assays. This study contributes evidence to support the inclusion of minority assays for M184V surveillance, while the routine inclusion of NNRTI mutation assays for Y181C and K103N is not supported by these data. Their application is not at present recommended for routine diagnostic purposes. Further studies are required to identify whether minority mutation assays are only
relevant for detection of ‘high fitness’ cost mutations. Application of ultra-deep sequencing would be useful to confirm the high rate of M184V found in this study and phylogenetics to determine linkage between test specimens; however, their use was beyond the scope of this study. We thank Elaine McKinney for her help with serological incidence testing. The study was funded by a Health Protection Agency research and development grant. Disclaimer The findings and conclusions of in this paper are those of the authors and do not necessarily represent the views of the agencies from which the authors come. The use of trade names is for identification only and does not constitute recommendations by the agencies from which the authors come. “
“HIV-infected patients are commonly prescribed several medications and are thus at risk for drug interactions that may result in QTc prolongation.