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USE OF GENOTYPIC HIV DNA TESTING: A DELPHI-TYPE CONSENSUS Short running title: Delphi Consensus on Genotypic HIV DNA Testing
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Edité par CCSD ; Oxford University Press (OUP) -
International audience. Abstract Objectives:As many disparities in the clinical use of HIV DNA sequencing are observed, a DELPHI-type consensus was initiated in France to homogenize use, techniques, and interpretation of results.Methods: Based on a literature review and clinical experience, a Steering Committee (SC) of eight virologists and one infectious disease specialist formulated statements. Statements were submitted to an independent and anonymous electronic vote of virologists and HIV clinicians in France, between October and December 2022. Results: The SC developed 20 statements grouped into six categories: clinical situations for the use of HIV DNA genotyping; techniques for performing HIV DNA genotyping; consideration of APOBEC mutations; genotyping results reporting; recycling of antiretrovirals; availability of HIV DNA genotyping tests and delays. Twenty-one virologists and 47 clinicians participated in two voting rounds and 18/20 (90%) assertions reached a ‘strong’ consensus. For example, that prior genotyping on HIV DNA is useful for clinical decision-making when considering switching to some long-acting regimens or to reduce the number of antiretroviral agents in virologically suppressed patients for whom RNA data are unavailable / not exploitable / not sufficiently informative. Two statements achieved no consensus: reporting any detected viral minority population for discussion in multidisciplinary meetings (virologists), and possible risk of virologic failure when using a second generation InSTI + XTC regimen in patients with undetectable viral load ≥1 year and in the presence of a documented M184V mutation <5 years (clinicians).Conclusion: This DELPHI-type consensus will facilitate the strengthening and harmonization of good practice when performing HIV DNA sequencing.
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