Antiretroviral Guidelines

US DHHS Guidelines with Australian commentary

Co-receptor Tropism Assays

Last Updated: October 25, 2018; Last Reviewed: October 25, 2018

Panel's Recommendations Regarding Co-receptor Tropism Assays

Panel’s Recommendations


A co-receptor tropism assay should be performed whenever the use of a CCR5 co-receptor antagonist is being considered (AI). Co-receptor tropism testing is recommended for patients who exhibit virologic failure on a CCR5 antagonist (BIII). A phenotypic tropism assay is preferred to determine HIV-1 co-receptor usage (AI). A genotypic tropism assay should be considered as an alternative test to predict HIV-1 co-receptor usage (BII). A proviral DNA tropism assay can be utilized for patients with undetectable HIV-1 RNA when a CCR5 antagonist is considered for use in a new regimen (e.g., as part of a regimen switch or simplification) (BII).
Rating of Recommendations: A = Strong; B = Moderate; C = Optional Rating of Evidence: I = Data from randomized controlled trials; II = Data from well-designed nonrandomized trials or observational cohort studies with long-term clinical outcomes; III = Expert opinion

A co-receptor tropism assay should be performed whenever the use of a CCR5 co-receptor antagonist is being considered (AI).
Co-receptor tropism testing is recommended for patients who exhibit virologic failure on a CCR5 antagonist (BIII).
A phenotypic tropism assay is preferred to determine HIV-1 co-receptor usage (AI).
A genotypic tropism assay should be considered as an alternative test to predict HIV-1 co-receptor usage (BII).
A proviral DNA tropism assay can be utilized for patients with undetectable HIV-1 RNA when a CCR5 antagonist is considered for use in a new regimen (e.g., as part of a regimen switch or simplification) (BII).

Rating of Recommendations: A = Strong; B = Moderate; C = Optional
Rating of Evidence: I = Data from randomized controlled trials; II = Data from well-designed nonrandomized trials or observational cohort studies with long-term clinical outcomes; III = Expert opinion