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18.10.3

Application for HIV drug resistance testing

Clinical HIV Guidelines, 5th Edition, 2022. Chapter 18, Continuing ART.

Clinical description

  • Patients on DTG- and PI-based regimens who don’t re-suppress below 1000 copies/ml after an

initial high VL despite good adherence need a genotype sample for resistance testing.

  • Contact the National HIV drug resistance (HIVDR) Expert Committee (either through DHA or

sending an email to 3rdlineart@lighthouse.org.mw) for a copy of the HIVDR testing application form (see Form 1 on page 135 in the Appendix). You can also access the application form from the DHA website https://dms.hiv.health.gov.mw or through your district ART coordinator.

  • Follow the instructions on the application form and ensure that the application form is completely

filled before sending it to the expert committee.

  • The expert committee will advise if a genotype sample needs to be collected. Genotyping is only

possible if the current VL is 1000+ and will be more reliable from 5000+.

  • The genotype result can only be interpreted correctly if the patient has been taking their ARVs

consistently for 2-3 months before the sample was collected.

  • Maintain the current regimen until genotyping results are available.
  • Follow the regimen recommendations from the National HIVRDR expert committee.
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