AEGiS-15IAC: The use of genotype resistance testing in HIV - infected patients in Sao Paulo (Brazil), before treatment with Tenofovir.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

The use of genotype resistance testing in HIV - infected patients in Sao Paulo (Brazil), before treatment with Tenofovir.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. A10445)

Bianco R, Diaz RD, Brito VC, Silveira OS
STD/AIDS Coordination of Sao Paulo City Health Department, Sao Paulo, Brazil

BACKGROUND: We analyzed resistance patterns and the utility of genotype in treatment before indicate Tenofovir. We used Brazilian interpretations based on a updated algorithim reflecting state of the art knowledge in Brazil.

METHODS: Retrospective analysis of ART - experienced patients seen in 15 out patient clinics in Sao Paulo, assessment of resistance by GT, and ART change. Genotyping was performed using Applied Sistems and mutants at codons: M41+L210w+M184 plus or Q 151 M, K65R, D65R, D67N, T215y, I69N, within the RT gene, with resistance to nucleoside and non-nucleoside reverse transcriptase inibitors.

RESULTS: The effect of the number and type of TAMs in HIV isolates at baseline on the viral response to therapy with Tenofovir was assessed in a pooled analysis of the genotypic resistance. 499 genotyping assays was made, 76 (15%) mutation were identified with partial reversion by Tenofovir DF and 87% presented with total resistance by Tenofovir. Those who had partial resistance 03 had taken 01 drug, 41 a combination of at least 02 drugs ARVs, 131 had taken 03 drugs and 07 had taken 04 drugs had 02 or more that failures. Total resistance: 03 had taken 01 drug, 16 a combination of at least 02 drugs, 51 had taken 03 drugs, 16 had taken 04 drugs, 01 had taken 05 drugs. Drugs ARVs include scheme - 71 AZT, 70 3TC, 41 D4T, 23 DDI partial resistance. Total resistance: AZT 94, DDI 86, 3TC 77, D4T 85.

CONCLUSION: GT guided ART change. Sucess was predicted by the number of drugs the patient had previously used. There was a trend to better success in those with< 02 ART drug class resistance. A high prevalence (more than 03 change ARV) using of NN resistance from patients with treatment failure justifies routine genotyping that will have using Tenofovir in the Brazil.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV, Adenine, HIV Seropositivity, Organophosphorus Compounds, Anti-HIV Agents, Zidovudine, HIV Infections, Stavudine, HIV-1 Reverse Transcriptase, HIV-1, Genotype, Research Design, Double-Blind Method, Brazil, tenofovir, Humans, therapy, genetics

040711
A10445