Hiv-1 drug resistance is a significant factor for treatment failure and drug susceptibility testing is recommended by u.S. And european treatment guidelines, however, the interpretation of resistance test results remains a challenge. An urgent need for a more standardized interpretation of resistance test results in the clinical setting and in the drug development process has been identified. A standardized approach for a clinical database derived definition of drug resistance for each individual drug requires extensive collaboration across academia and industry. In addition, issues related to standardization and quality assurance of technologies and reimbursement need to be addressed.