Arroyo E, Tampe CR, Rivera-Vazquez C, Gonzalez G, Saavedra S, Ramirez-Ronda CH; International Conference on AIDS.

Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. MoPeB3140.

VAMC, San Juan, Puerto Rico

BACKGROUND: To study HIV resistance in Hispanic antiretroviral therapy (ART) experienced patients, and response after genotype (GT)-guided ART changes. METHODS: A retrospective analysis of ART-experienced patients seen in an outpatient clinic in Puerto Rico, assessment of resistance by GT, and evaluation of virologic response after GT-guided ART change. RESULTS: 84 pts., all ART-experienced Hispanic men, had 92 GTs performed for ART failure. 73% had > 1 prior change in their ART, 89% were using > 3 ART drugs. Prior exposure to all 3 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 (range 3-60). Mean VL was 40,000 (811-750,000). Resistance by GT to all 3 drug classes was seen in 26% of pts., to 2 classes in 48%, and to 1 class in 14%. 12% of pts. had wild-type virus. 86% had resistance to NRTI, 55% to PI, and 46% to NNRTI. 58 pts. had a GT-guided ART change. VL decrease >.5 log was seen in 57% of pts. within 16 weeks. 34% reached VL <400. New ART included 2 sensitive drugs in 69% of pts., only 28% had > 2 sensitive drugs. Success in pts. having used <3 drugs in the past was 100%, those having used 3-7 drugs 59%, and those having used >7 drugs 20% (P=.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. Success did not depend on the number of sensitive drugs, nor on the number of new drugs added. CONCLUSIONS: GT-guided ART change was associated with 59% virologic success in this clinic, despite having a heavily ART-experienced and heavily resistant population. Success was predicted by the number of drugs the patient 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 patient's ART.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Anti-HIV Agents
• Antiretroviral Therapy, Highly Active
• Drug Therapy, Combination
• Genotype
• HIV
• HIV Infections
• HIV Protease Inhibitors
• HIV Seropositivity
• Humans
• Male
• Puerto Rico
• drug therapy
• genetics
• therapy

Other ID:

• GWAIDS0018305

UI: 102255803

From Meeting Abstracts