HIV Resistance Meeting Web Reports.Each summer there is a small, invitation-only International Workshop on HIV Drug Resistance 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 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 resistance. * Treatment-naive patients with novel mutations at 215 are at risk for rapid selection of resistance to zidovudine. * Data continue to confirm that stavudine and zidovudine are cross-resistant. * Presence of mutations at codons codon /co·don/ (ko´don) a series of three adjacent bases in one polynucleotide chain of a DNA or RNA molecule, which codes for a specific amino acid. co·don (k  82, 54, and 10 together with 4 additional PI resistance mutations is significantly associated with failure of lopinavir lopinavir /lo·pin·a·vir/ (lo-pin´ah-vir) an antiviral HIV protease inhibitor, used with ritonavir in the treatment of HIV infection./ritonavir. * Ritonavir 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. in·din·a·vir ( 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 - California Christmas Tree Growers CCTG - Campus California Teacher Group 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 lamivudine /la·miv·u·dine/ (lah-miv´u-den) a nucleoside analogue that inhibits reverse transcriptase, used as an antiviral agent in the treatment of chronic hepatitis B and, in combination with zidovudine, the treatment of HIV infection and AIDS. la·miv·u·dine resistance. * The majority of zidovudine- and abacavir abacavir /abac·a·vir/ (ah-bak´ah-vir) a nonnucleoside reverse transcriptase inhibitor used as the sulfate salt as an antiretroviral in the treatment of human immunodeficiency virus infection.-resistant viruses remain susceptible to tenofovir, although cross-resistance cross-resistance /cross-re·sis·tance/ (kros-re-zis´tans) multidrug resistance. is observed in virus with multi-NRTI NRTI - Neighborhood Reinvestment Training Institute NRTI - Nucleoside Reverse Transcriptase Inhibitor (therapy) 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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