Six RCTs (1,471 patients) were included. Four RCTs evaluated genotype resistance tests (708 patients), one RCT (541 patients) examined both phenotype and genotype tests, and one RCT (221 patients) looked at a phenotype test. Of the 551 patients treated on the basis of genotype results, expert advice was provided for 143 patients.
Genotype testing.
The rate of patients with undetectable viral load after 3 months (6 RCTs) was 42.6% in patients treated on the basis of genotype results and 33.2% in patients treated based on SOC (OR 1.7, 95% CI: 1.3, 2.2, P<0.0001; heterogeneity, P=0.60).
The rate of viral suppression achieved when clinicians were helped by expert advice was 50.77% for the genotype group and 35.8% for SOC (OR 2.4, 95% CI: 1.5, 3.7, P=0.0001; heterogeneity, P=0.30). The rates of viral suppression achieved when the test results were interpreted by the clinicians without expert advice were 36.4% and 31.5% for the genotype group and SOC, respectively (OR 1.4, 95% CI: 1.0, 1.9, P=0.0053; heterogeneity, P=0.27).
The rate of patients with undetectable viral load after 6 months (4 RCTs) was 38.8% in patients treated on the basis of genotype results and 28.7% in patients treated based on SOC (OR 1.6, 95% CI: 1.2, 2.2, P=0.0005; heterogeneity, P=0.65).
Phenotype testing.
The rate of patients with undetectable viral load after 3 months (2 RCTs) was 37.5% in patients treated on the basis of phenotype results and 33.8% in patients treated based on SOC (OR 1.1, 95% CI: 0.8, 1.6, P=0.32; heterogeneity, P=0.15).