Chapter 110 : Susceptibility Test Methods: Viruses

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This chapter discusses the clinical situations in which antiviral resistance has emerged, thus necessitating in vitro susceptibility testing. It provides an overview of the phenotypic and genotypic susceptibility testing methods that have been employed to detect resistance. Persistent or worsening herpes simplex virus type 1 (HSV-1) or varicella zoster virus (VZV) infection while on acyclovir (ACV) may indicate drug resistance. Persistent or worsening human cytomegalovirus (HCMV) retinitis, pneumonitis, or colitis unresponsive to ganciclovir may also indicate drug-resistant virus. Monitoring for Human Immunodeficiency Virus type 1 (HIV-1) antiretroviral resistance is essential when beginning antiretroviral therapy (ART), for assessing failure of a particular regimen to suppress HIV replication and to test for cross-resistance to alternative antiretroviral drugs to aid in selection of appropriate salvage therapy. The plaque reduction assay (PRA) has been the "standard" method of antiviral susceptibility testing. A number of phenotypic assays are in use for testing of HIV-1 isolate susceptibility to nucleoside analog RT inhibitors. The major advantage of genotypic assays is the relatively rapid turnaround time compared to phenotypic assays. Multicenter studies were carried out to compare sequencing results among participating laboratories for detection of reverse transcriptase (RT) mutations. In this study, sequence concordance was high, even though different editing strategies were used by different labs, but 12% of the resistance mutations present in the 10 electronic files that were distributed and analyzed were not identified in some labs.

Citation: Arens M, Swierkosz E. 2011. Susceptibility Test Methods: Viruses , p 1729-1743. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch110

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Human immunodeficiency virus 1
Herpes simplex virus 1
Restriction Fragment Length Polymorphism
Murine leukemia virus
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Proposed guidelines for antiviral susceptibility results of herpes group and influenza A viruses

Citation: Arens M, Swierkosz E. 2011. Susceptibility Test Methods: Viruses , p 1729-1743. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch110

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