AIDS TREATMENT NEWS Issue #368, July 13, 2001
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 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 82, 54, and 10 together with 4 additional PI resistance mutations is significantly associated with failure of lopinavir/ritonavir.
* Ritonavir boosting of indinavir 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 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).
Other reports are can be found at:
http://www.hivandhepatitis.com/2001conf/hivresis/main.html
http://www.natap.org/2001/5thresist/ndx5thresist.htm
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