HIV-2 Resistance Interpretation and Case Report PD Dr. Martin - PowerPoint PPT Presentation

HIV-2 Resistance Interpretation and Case Report PD Dr. Martin Stürmer Institute for Medical Virology University Clinic Frankfurt/Main

HIV-2 Wildtype � What happens, if you submit the HIV-2 wildtype sequence ROD to online-tools for interpretation of HIV drug resistance?

HIV-2 Wildtype

HIV-2 Wildtype

HIV-2 Wildtype � And where is the Protease???

HIV-2 Wildtype

HIV-2 Wildtype

HIV-2 Resistence Interpretation � NRTIs – no concordance between algorithms – 3TC, FTC, ABC, TDF < ddI < AZT, d4T � NNRTIs – Forget it � PIs – some concordance between algorithms – SQV < DRV, LPV < NFV < IDV, ATV < FPV, TPV � INIs – Yes

HIV-2 Resistence Interpretation � Current approach – PR: enter all AA differences from consensus HIV-1 manually into the algorithm – RT: submit the complete sequence to the algorithm – IN: submit the complete sequence to the algorithm � Is this correct? – What do we know about interactions between mutations in HIV-2???

Case Report � Male Portuguese patient � Risk unknown � First positive HIV test 01/1991 � First visit in FFM 09/2000 with 55 CD4 (13,8%) and 41.400 copies/ml � Therapy start 02/2003

Case Report 100.000 800 ] m l / n 10.000 C e 600 D i p 4 o 1.000 K [ Z [ 400 e A l 100 l N e < 100 n R / 200 µ V 10 l ] I H 1 0 Sep. May. Dez. Dez. Sep. Feb. Jul. Jan. Sep. Apr. 00 03 03 04 05 07 07 08 08 09 AZT AZT 3TC 3TC TDF TDF FTC FTC LPV/r LPV/r Adverse Event: high blood fat values

Case Report 100.000 800 ] m l / n 10.000 C e 600 D i p 4 o 1.000 K [ Z [ 400 e A l 100 l N e < 100 n R / 200 µ V 10 l ] I H 1 0 Sep. May. Dez. Dez. Sep. Feb. Jul. Jan. Sep. Apr. 00 03 03 04 05 07 07 08 08 09 AZT AZT 3TC 3TC TDF TDF FTC FTC LPV/r LPV/r Resistance Test

Discussion

Case Report 100.000 800 ] l m / n 10.000 C e 600 D i p 4 o 1.000 K [ Z [ 400 e A l 100 l N e < 100 n R / 200 µ V 10 l ] I H 1 0 Sep. May. Dez. Dez. Sep. Feb. Jul. Jan. Sep. Apr. 00 03 03 04 05 07 07 08 08 09 AZT AZT 3TC 3TC TDF TDF FTC FTC LPV/r LPV/r DRV/r DRV/r SQV/r SQV/r RAL RAL