Abstract

Recent guidelines include clear recommendations for resistance testing in individuals infected by HIV for less than 2 years with the assumption that within 1--2 years most drug-resistance mutations (DRM) would be overgrown by wild-type virus. Recent studies addressed at monitoring the persistence of resistance-associated mutations after HIV transmission to untreated patients indicate that certain DRM are highly stable and may persist at detectable levels for many years. The usefulness of genotypic testing in all drug-naive patients in most settings is under debate. The picture of the events that occur in naive patients is probably complex and a different and more frequent analysis probably needs to be performed. (excerpt)

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