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Abstract
THE VIRTUAL PHENOTYPE IS A SUPERIOR INDEPENDENT PREDICTOR OF CLINICAL RESPONSE THAN GENOTYPING WITH A COMMON RULES BASED INTERPRETATION
LARDER B, PEETERS M, VERBIEST W, HARRIGAN R, GRAHAM N
Background: Retrospective studies have correlated baseline drug resistance (phenotype and genotype) with clinical response. We wished to determine the relative predictive value of the VirtualPhenotypeâ„¢ (an averaged phenotype based on database matching of genotypes with phenotypes) compared with genotyping
Methods: Baseline samples from 191 patients enrolled in VIRA3001 (prospective phenotypic resistance study) were analysed in terms of viral load response (failure to reach <400 RNA copies/ml) at week 16. Virtual phenotypes were derived from the genotype (ABI sequencing) using a large relational database. Uni-and multivariate analyses were performed on genotype, phenotype (Antivirogram®) and virtual phenotype, according to the Resistance Collaborative Group data analysis plan.The predictive value of PSS, vPSS & GSS were then compared using a non-parametric receiver operator characteristic (ROC) analysis.
Results: The genotype analysis (dropouts as censored, DAC) was a significant predictor of response in the univariate model with an odds ratio (OR) of 0.69 (CI=0.51-0.93), p=0.015, but not in the multivariate model, OR=0.81 (CI=0.57-1.14), p=0.22. In contrast, the virtual phenotype was a highly significant predictor of response in both models: univariate OR=0.39 (CI=0.26-0.58), p<0.0001, and multivariate OR=0.49 (CI=0.31-0.76), p=0.0014.The real phenotype was also a significant predictor of response in both analyses. The results of the ROC analysis demonstrated that the virtual phenotype and phenotype were both significantly more predictive of treatment response than the genotype (p=0.01 and p=0.03 respectively)
Conclusions: In this study virtual phenotype, but not genotype, was a significant independent predictor of response. Virtual phenotype proved significantly more predictive than the genotype and at least comparable to real phenotype. The data support the use of the virtual phenotype as a clinical support tool over genoptyping with rules-based interpretation
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
125
Suggested Citation
"LARDERB, et al.
THE VIRTUAL PHENOTYPE IS A SUPERIOR INDEPENDENT PREDICTOR OF CLINICAL RESPONSE THAN GENOTYPING WITH A COMMON RULES BASED INTERPRETATION.
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
125"
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