F6/8 - THE Q151M MUTATION IN THE HAART ERA: ANALYSIS OF DETERMINANTS, DYNAMICS AND RESPONSE TO TREATMENTS, USING A LARGE DATA-BASE OF PATIENTS UNDERGOING GENOTYPE RESISTANCE TEST (GRT) AFTER FAILURE

9^TH EUROPEAN AIDS CONFERENCE (EACS)
1^st EACS RESISTANCE & PHARMACOLOGY WORKSHOP

October 25 - 29, 2003 Warsaw, Poland

3.4 Resistance Testing in Clinical Practice

F6/8 - THE Q151M MUTATION IN THE HAART ERA: ANALYSIS OF DETERMINANTS, DYNAMICS AND RESPONSE TO TREATMENTS, USING A LARGE DATA-BASE OF PATIENTS UNDERGOING GENOTYPE RESISTANCE TEST (GRT) AFTER FAILURE

* Zaccarelli M., Perno C.F., Forbici F., Soldani F., Bonfigli S., Gori C., Trotta M.P., Bellocci M.C., Liuzzi G., D'Arrigo R., Boumis E., De Longis P., Bellagamba R., Narciso P., Antinori A.

National Institute for Infectious Diseases "Lazzaro Spallanzani", Rome, Italy

Objectives: The aim of the present analysis performed in HAART patients was to evaluate: factors related to the detection of Q151M, dynamics of its appearance/disappearance upon treatment changes and possibility of assess effective new treatments in patients harbouring Q151M.

Methods: A database of patients failing a HAART regimen, undergoing for first time GRT was analyzed. Patients were also evaluated after GRT in order to evidence the effect of Q151M over the response to treatment.

Results: Overall, 470 patients were included. Main characteristics: male 69%; CDC-C3 35%; median number of pre-GRT treatment n. 3. The proportion of patients carrying Q151M was 3.6%. At multivariate analysis, the presence of Q151M was significantly associated with younger age; CD4+ count <150/mm³ at GRT, HIV-RNA >70000 c/ml; >2 pre-GRT treatment regimens and longer duration of the last failing pre-GRT treatment. In contrast, Q151M was inversely associated to pre-GRT AIDS diagnosis, and longer pre-GRT treatment with 3TC. To note, detection of M184V was inversely associated to Q151M. No association with duration of treatment with NRTI other than 3TC was found. Five patients, carrying Q151M, undergoing programmed treatment interruption experienced full reversion of Q151M within 4-11 months after GRT. After interruption, virological success was obtained in 4/5 (80%) of them.

Conclusions: Our data indicate that many different demographic, clinical and laboratory factors can support the appearance of Q151M mutation. Salvage regimens can be effective even in presence of Q151M and limited drug options.

Presenting Author: MD Mauro Zaccarelli, National Institute for Infectious Diseases "Lazzaro Spallanzani"., Via Portuense 292, 00149, Roma, Italy, Phone: +39-06-55170368

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