Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested
CPT4 code
Name of the Procedure:
Infectious Agent Phenotype Analysis by Nucleic Acid (DNA or RNA) with Drug Resistance Tissue Culture Analysis, HIV 1; First through 10 Drugs Tested
Summary
This procedure involves analyzing the genetic material (either DNA or RNA) of the HIV-1 virus to determine which drugs can effectively target and treat the infection. The analysis helps to identify any resistance the virus may have to certain drugs, guiding doctors to choose the most appropriate medications for treatment.
Purpose
The procedure is designed to:
- Identify drug-resistant strains of HIV-1.
- Guide tailored treatment plans.
- Monitor the effectiveness of antiretroviral therapy.
Indications
- HIV-positive patients showing signs of treatment failure.
- Individuals newly diagnosed with HIV-1, particularly if starting treatment.
- Patients with a high viral load.
Preparation
- No fasting is required.
- Blood samples are necessary, and patients should follow any specific instructions provided by their doctor.
- Pre-procedure consultation to review current medications and health conditions.
Procedure Description
- Blood Sample Collection: A blood sample is taken from the patient.
- Nucleic Acid Extraction: The genetic material (DNA/RNA) of the HIV-1 virus is extracted from the blood sample.
- Amplification and Sequencing: The genetic material is amplified and sequenced to identify specific viral genes.
- Drug Resistance Analysis: The virus is cultured in the presence of different drugs to observe its response.
- Data Interpretation: Results are analyzed to determine which drugs the virus is resistant to and which it is susceptible to.
Tools and equipment:
- PCR (Polymerase Chain Reaction) machines
- Sequencers
- Tissue culture systems
Duration
The entire procedure, from sample collection to results, typically takes 7-14 days.
Setting
The procedure is performed in a specialized laboratory setting, with blood sample collection done in a hospital or clinic.
Personnel
- Laboratory technicians specialized in molecular biology.
- Infectious disease specialists.
- HIV treatment providers.
Risks and Complications
- Mild discomfort from blood sample collection.
- Rare risk of infection at the site of blood draw.
Benefits
- Identification of the most effective drugs for the patient.
- Increased chances of successful HIV treatment.
- Reduced risk of developing multi-drug-resistant HIV strains. Results are typically realized within a few weeks.
Recovery
- Minimal recovery needed; patients can resume normal activities immediately after blood draw.
- Follow-up appointments to discuss results and adjust treatment plans accordingly.
Alternatives
- Genotypic resistance testing (analyzing the genetic mutations).
Clinical monitoring of treatment responses.
Pros: Genotypic testing is faster and less costly. Cons: May not provide direct drug resistance information like phenotypic analysis.
Patient Experience
- During: Possible slight pain or discomfort during blood draw.
- After: Typically, the patient feels normal, with no significant pain. Comfort is ensured through proper blood draw techniques, and pain management is unnecessary as the process involves minimal discomfort.