HIV Resistance Meeting Web Reports.Each summer there is a small, invitation-only International Workshop on HIV Drug Resistance HIV drug resistance Antiretroviral drug resistance AIDS The resistance of a strain of HIV to an agent–eg, a reverse transcriptase inhibitor, which occurs in 5%-20% of those newly infected with HIV and Treatment Strategies; this year the 5th workshop in this series was held June 4-8, 2001 in Scottsdale, Arizona. Recently, a 9000-word detailed technical report of this meeting, written by leading HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. researcher Daniel R. Kuritzkes, M.D., was published on Medscape: http://hiv.medscape.com. This report should be read by HIV-specialist physicians and other medical professionals; most patients will find it difficult, but may want to scan it to look for any information that might be relevant to their treatment. Dr. Kuritzkes summarized the highlights "perhaps of most immediate relevance to day-to-day clinical practice": * Y318F is a newly recognized mutation associated with NNRTI NNRTI Non-nucleoside reverse transcriptase inhibitor, see there resistance. * Treatment-naive patients with novel mutations at 215 are at risk for rapid selection of resistance to zidovudine zidovudine /zi·do·vu·dine/ (zi-do´vu-den) a synthetic nucleoside (thymidine) analogue that inhibits replication of some retroviruses, including the human immunodeficiency virus; used in the treatment of HIV infection and AIDS. . * Data continue to confirm that stavudine and zidovudine are cross-resistant. * Presence of mutations at codons 82, 54, and 10 together with 4 additional PI resistance mutations is significantly associated with failure of lopinavir/ritonavir. * Ritonavir ritonavir /ri·to·na·vir/ (ri-to´nah-vir) an HIV protease inhibitor used in treatment of HIV infection and AIDS. ri·ton·a·vir n. boosting of indinavir indinavir /in·di·na·vir/ (in-di´nah-vir) an HIV protease inhibitor that causes formation of immature, noninfectious viral particles; used as the sulfate salt in the treatment of HIV infection and AIDS. may partially overcome indinavir resistance. * Resistance mutations confer a loss of viral fitness relative to wild-type, but the clinical significance of this remains unclear. * The CCTG CCTG Campus California Teacher Group CCTG California Christmas Tree Growers 575 study failed to show a benefit from phenotyping in guiding the selection of a salvage regimen, except in the subgroup of patients with virus resistant to more than 3 protease inhibitors at baseline. * The benefits and risks of treatment interruptions are still under investigation, but risks may include emergence of lamivudine resistance. * The majority of zidovudine- and abacavir-resistant viruses remain susceptible to tenofovir, although cross-resistance is observed in virus with multi-NRTI resistance. * New technologies to assess resistance to entry inhibitors such as T-20 and T-1249 are in development. The abstracts and other reports from the meeting may be available through http://www.intmedpress.com (after a complicated registration procedure). |
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