Consensus drug resistance mutations for epidemiological surveillance: basic principles and potential controversies

Antivir Ther. 2008;13 Suppl 2(0 2):59-68.


Programmes that monitor local, national and regional levels of transmitted HIV-1 drug resistance inform treatment guidelines and provide feedback on the success of HIV-1 treatment and prevention programmes. The World Health Organization (WHO) has established a global programme for genotypic surveillance of HIV-1 drug resistance and has recommended the adoption of a consensus definition of genotypic drug resistance. Such a definition is necessary to accurately compare transmitted drug resistance rates across geographical regions and time periods. HIV-1 diversity and the large number of mutations associated with antiretroviral drug resistance complicate the development of a consensus definition for genotypic drug resistance. This paper reviews the data that must be considered to determine which of the many HIV-1 drug resistance mutations are likely to be both sensitive and specific indicators of transmitted drug resistance. The process used to create a previously published list of drug resistance mutations for HIV-1 surveillance is reviewed and alternative approaches to this process are discussed.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Anti-Retroviral Agents / therapeutic use*
  • Cluster Analysis
  • DNA Mutational Analysis
  • Databases, Genetic
  • Developing Countries
  • Drug Resistance, Viral / genetics*
  • Epidemiologic Research Design*
  • Genotype
  • Global Health*
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • HIV Infections* / transmission
  • HIV Infections* / virology
  • HIV-1 / genetics*
  • Humans
  • Mutation*
  • National Health Programs
  • Online Systems
  • Phylogeny
  • Polymorphism, Genetic
  • Population Surveillance
  • Program Development
  • Terminology as Topic
  • Treatment Outcome
  • World Health Organization*


  • Anti-Retroviral Agents