Hauke Walter Medizinisches Labor Stendal News ticker Changes in - PowerPoint PPT Presentation

Hauke Walter Medizinisches Labor Stendal

News ticker • Changes in the scoring system • Update the algorithms • New drugs • Other targets: • HCV resistance tool is mediated via geno2pheno (like HIV coreceptor) • HBV (HBs escape mutation tool is going to be destressed) • …

Scoring system • A 4-class interpretation system used: • S " susceptible " indicates full susceptibility of a virus to a certain drug without any limitations in terms of resistance. • LS " limited susceptibility " hints for low level resistance which should not lead to immediate therapy failure, but may contribute to less sustained response • I " intermediate " resistance is indicated if severe limitations in susceptibility have to be expected and the drug can not count for a fully active drug any more. However, these drugs can still be very useful in situations with generally limited options (salvage). • R " resistant " indicates that high level drug resistance has to be expected. We realized that for different drugs LS was developed not consistently but using a mixture of understandings anywhere between low level resistance and lowered genetic barrier

LS was skipped • All algorithms were re-evaluated and mutations resulting in LS interpretation were either skipped or cause now a flag (comment) only. • In order to • facilitate readability • and to harmonize interpretation

Update the algorithms • Special focus on ABC: • Resistance interpretation for ABC is the worst of all drugs in order to predict therapy response • Drug exposure tool (A. Pironti) can be used to identify more player mutations to be integrated in the interpretation tool

New drugs • Doravirine done • Cabotegravir in progress (nearly done) • Bictegravir in progress (nearly done) • Fostemsavir should go online at the end of the year (but not before approval)

Other targets • CMV • to be addressed: • Drug resistance mutations • Cellular immunologic response • In cooperation with the university of Ulm (Thomas Stamminger, Peter Lischka) • There is an existing tool addressing CMV resistance • Needs to be integrated in an easy-to-use tool like GRADE

Other targets • HIV-2 • The existing cooperation is ongoing (internationally) • German NRC has successfully generated new HIV-2 isolates • If you have patient material (EDTA blood) to provide please contact Josef Eberle • In order to phenotype them and to improve interpretation

Thank you