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|Test code||MOLT (Order in Apex as 'Miscellaneous Outside Lab Test' using the complete test name above)|
|Performed by||Monogram Bioscience|
|Collection Instructions||Note: If both genotyping and phenotyping are requested for B&T patients, TWO separate tubes should be drawn.|
|Container type||Lavender top|
|Amount to Collect||6 mL blood|
|Sample type||EDTA Plasma|
|Preferred volume||3 mL plasma|
|Min. Volume||3 mL plasma|
|Processing notes||Centrifuge sample @ 100-1200g x 10-15 min. and separate plasma within 6 hours of sample collection. Transfer plasma to capped plastic tube and freeze at -20C. Do not thaw sample after freezing. Ship frozen with dry ice.
Note: If both genotyping and phenotyping are requested for B&T patients, aliquot the two tubes separately and freeze at -20C.
|Additional information|| Note: Patients must have a viral load of at least 500 copies/mL for genotyping to be performed.
Drug-Resistance Testing (Last updated February 12, 2013; last reviewed February 12, 2013: http://aidsinfo.nih.gov/guidelines)
· HIV drug-resistance testing is recommended in persons with HIV infection at entry into care regardless of whether antiretroviral therapy (ART) will be initiated immediately or deferred (AII). If therapy is deferred, repeat testing should be considered at the time of ART initiation (CIII).
· Genotypic testing is recommended as the preferred resistance testing to guide therapy in antiretroviral (ARV)-nave patients (AIII).
· Standard genotypic drug-resistance testing in ARV-naive persons involves testing for mutations in the reverse transcriptase (RT) and protease (PR) genes. If transmitted integrase strand transfer inhibitor (INSTI) resistance is a concern, providers may wish to supplement standard genotypic resistance testing with an INSTI genotype test (CIII).
· HIV drug-resistance testing should be performed to assist in the selection of active drugs when changing ARV regimens in persons with virologic failure and HIV RNA levels >1,000 copies/mL (AI). In persons with HIV RNA levels >500 but <1,000 copies/mL, testing may be unsuccessful but should still be considered (BII).
· Drug-resistance testing should also be performed when managing suboptimal viral load reduction (AII).
· In persons failing INSTI-based regimens, genotypic testing for INSTI resistance should be performed to determine whether to include a drug from this class in subsequent regimens (AII).
· Drug-resistance testing in the setting of virologic failure should be performed while the person is taking prescribed ARV drugs or, if not possible, within 4 weeks after discontinuing therapy (AII).
· Genotypic testing is recommended as the preferred resistance testing to guide therapy in patients with suboptimal virologic responses or virologic failure while on first or second regimens (AII).
· The addition of phenotypic to genotypic testing is generally preferred for persons with known or suspected complex drugresistance mutation patterns, particularly to protease inhibitors (PIs) (BIII).
· Genotypic resistance testing is recommended for all pregnant women before initiation of ART (AIII) and for those entering pregnancy with detectable HIV RNA levels while on therapy (AI)
|Last Updated||2/20/2014 3:08:05 PM|