Rivera-Vazquez C, Arroyo E, Tampe C, Gonzalez G, Saavedra S, Ramirez-Ronda C; IAS Conference on HIV Pathogenesis and Treatment (2nd : 2003 : Paris, France).
Antivir Ther. 2003; 8 (Suppl.1): abstract no. 819.
VA Medical Center and University of PR, San Juan, PR, USA
PURPOSE: To study HIV resistance in antiretroviral therapy (ART) experienced veteran pts and response to therapy after GT ART changes. METHOD: A retrospective analysis of ART-experienced pts, assessment of resistance by GT and evaluation of virologic and immunologic response after GT-guided ART change. 84 pts, all ART-experienced male veterans, had 92 GTs performed for ART failure. 73% had >1 prior change in their ART, 89% were using >3 drugs. Prior exposure to all three drug classes was seen in 35% of pts, to NRTI+PI in 38% to NRTI+NNRTI in 18% and to only NRTI in 9%. Mean ART length was 38 months. Mean VL was 40 k. Resistance by GT to all three drug classes was seen in 26% of pts, to two classes in 48% and to one class in 14%. 12% of pts had WT virus. 86% had resistance to NRTI, 55% to PI and 46% to NNRTI. 58 pts had a GT-guided ART change. VL decrease >0.5 log was seen in 57% of pts within 16 weeks. 34% reached VL <400. New ART included two sensitive drugs in 69% of pts. Only 28% had >2 sensitive drugs. Success in pts who used <3 drugs in the past was 100%, those having used 3-7 drugs 59% and those having used >7 drugs 20% (P=0.05). Pts with resistance to <2 drug classes were more likely to have virologic success, vs those with higher resistance (71% vs 57%), but not significantly so. 73% of pts with pre-treatment CD4 <200 exhibited an - in total CD4 after ART change vs 36% response in pts with CD4 >200. 64% of pts showed - in CD4 after ART change. Success did not depend on the number of sensitive drugs, nor on the number of new drugs added. CONCLUSION: GT-guided ART change was associated with 57% virologic success in this clinic, despite having a heavily ART-experienced and heavily-resistant population. Success was predicted by the number of drugs the pt had previously used. There was a trend to better success in those with <2 ART drug class resistance. Success was not predicted by the number of sensitive drugs nor the number of new drugs in the pt's ART.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Anti-HIV Agents
- Antiretroviral Therapy, Highly Active
- Drug Therapy, Combination
- Genotype
- HIV
- HIV Infections
- Male
- drug therapy
- genetics
- immunology
- instrumentation
- therapy
- virology
Other ID:
UI: 102263098
From Meeting Abstracts