9th Annual Conference Of The British HIV Association [BHIVA]


24 – 26 April 2003, University of Manchester
Institute of Science & Technology (UMIST)
Manchester


[TITLE:] THE IMPACT OF NRTI RESISTANCE MUTATIONS ON RESPONSES TO TENOFOVIR AS PART OF SALVAGE THERAPY IN AN ETHNICALLY DIVERSE POPULATION OF DRUG-EXPERIENCED PATIENTS IN SOUTH LONDON

[AUTHOR(S):] C McDonald1, R Kulasegaram2, M Smith1, S Kegg3, C Taylor1, P Easterbrook1, B Peters2, P Hay3 and AM Geretti1
1 King's College Hospital, 2 St Thomas's and 3 St George's Hospital, London, UK

BHIVA Conf 2003 Apr 24-26;9:P1

OBJECTIVE: To assess 48-week virological and immunological responses to salvage highly active antiretroviral therapy (HAART) in ethnically diverse highly drug-experienced patients with nucleoside reverse transcriptase inhibitor (NRTI) mutations affecting tenofovir susceptibility.

METHODS: In a prospective study of patients failing HAART and starting tenofovir-based salvage therapy, genotypic resistance was assayed in plasma samples collected at the last failure and all available previous failures [TruGene Assay (Visible Genetics) or in-house sequencing].

RESULTS: 45 subjects (28 males and 17 females), 58% Caucasian, 38% black African and 4% black Caribbean, had a baseline median viral load (VL) of 4.2 log10 copies/ml (mean 5), median CD4 count 224 cells/µl (mean 263), mean 47 months of antiretroviral (ARV) therapy, mean eight ARV drugs, mean four failures and mean two NRTI resistance mutations with thymidine analogue mutations (TAMs) (41L, 67N, 70R, 210W, 215Y/F, 215Q) or 65R; 17 (38%) had 41L plus two other TAMs; 13 (29%) had 210W in any context; three (6%) had 65R. 32 patients reached 48 weeks, five of whom (16%) were lost to follow-up; six (19%) stopped therapy due to severe side effects in two (acquired Fanconi's; grade 3 hyperlipidaemia), intolerance in three and pregnancy in one. 14 (44%) had VL <400 and 12 (37.5%) <50 copies/ml. Virological failure occurred in six (19%). Mean CD4 count rise 84 cells/µl.

CONCLUSIONS:

PRESENTING AUTHOR: C McDonald

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Copyright © 2003 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD