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Review

Interpretation algorithms

Tobias Sing, Martin Däumer
Anna Maria Geretti
, editors.
In: Antiretroviral Resistance in Clinical Practice. London: Mediscript; 2006. Chapter 6.
Review

Interpretation algorithms

Tobias Sing et al.

Excerpt

Physicians treating HIV-1-infected patients are faced with selecting an optimal new regimen upon therapy failure. This task is highly complex because of the increasing number of available antiretroviral drugs, significant cross-resistance and the likely presence of archived drug-resistant viral variants selected by previous regimens. Parameters with potential impact on treatment decisions include the plasma viral load, CD4 cell count, viral genotype, phenotype and replication capacity, and pharmacological data. Other factors to consider include tolerability, toxicity and the ability to preserve future treatment options.

Interpretation algorithms are designed to assist the treating physician in choosing an optimal drug combination using information from drug-resistance testing. In this context, `interpretation' refers to the task of predicting a specific factor (i.e. drug activity or virological response) from one or more other factors. The word `algorithm' originates from computer science and denotes a set of well-defined instructions for accomplishing a given task. In clinical practice, the most popular interpretation algorithms are rule-based approaches for predicting drug activity from the viral genotype. Published reviews provide in-depth coverage of rule-based approaches [1,2]. However, the field has broadened considerably in scope and methodology, and new tools are currently being developed.

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