Antiretroviral therapy Response in non-B subtypes: Does subtype - PowerPoint PPT Presentation

Antiretroviral therapy Response in non-B subtypes: Does subtype matters? Ujjwal Neogi Karolinska Institute

Background Subtype does not matter in therapy response Clinic Infect Dis

• 99% of the known cases in Sweden are registered in the database • Every night there is update. • We used to download the database (with an unique ID in MS access) every year January. It mimics African HIV-Epidemic Viral Country Diagnosis ART suppression Country 1 Country 2 Country 3 (Sweden) 6934 95% 95% Country 4 Country 5 Country 6 Country 7 Colour coding : RED indicates an element was <70% of its predecessor; AMBER indicates an element which is 70-89% of its predecessor; GREEN indicates an element which is ≥ 90% of its predecessor (meeting Neogi et al 2014, Plos One that element of 90-90-90)

Factors associated with primary viral treatment failure A regimen failed to suppress the viral load within 9 months of the start of ART (ie, viral load >500 copies per mL if ART started between 1996 and 1998 or >50 copies per mL if started between 1999 and 2015

Time to secondary viral failure

Logistic regression model of odds of having missed one dose in the past 7 days

Molecular Docking

I. Subtypes probably affect the therapy response. II. It might be because of drug-protein interactions and/or naturally occurring polymorphisms in the drug binding sites. Challenges for LMICs: I. No viral load monitoring II. No drug resistance genotyping III. Poor adherence / adherence counselling (which is beyond anyone's control!!!). IV. Limited drug options Use the best drug where there is no problem in drug itself.

HIV-1C Cohorts: Prof. Anders Sönnerborg Karolinska Institutet, Sweden Dr. Susan Engelbrecht Dr. Graeme Jacobs Stellenbosch University, South Africa Dr. Nuno Faria Prof. Oliver Pybus Dr. Tasnim Azim Oxford University Dr. Mustafizur Rahman Dr. Kamalendra Singh icddr,b Prof. Stefan Sarafianos Dr. Luke Elisabeth Hanna University of Missouri National Institute of Research in Prof. Thomas Klimkait Tuberculosis, India University of Basel Dr. Amogne Wondwossen Addis Ababa University, Ethiopia Dr. Miguel E. Quinones-Mateu, Case Western Reserve University Dr. Aman Russom KTH-Scilife