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Background
Subtype does not matter in therapy response
Clinic Infect Dis
Antiretroviral therapy Response in non-B subtypes: Does subtype - - PowerPoint PPT Presentation
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
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- 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.
Country Diagnosis ART Viral 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 that element of 90-90-90)
It mimics African HIV-Epidemic
Neogi et al 2014, Plos One
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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
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Time to secondary viral failure
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Logistic regression model of odds of having missed
- ne dose in the past 7 days
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Molecular Docking
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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.
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- Prof. Anders Sönnerborg
Karolinska Institutet, Sweden
- Dr. Nuno Faria
- Prof. Oliver Pybus
Oxford University
- Dr. Kamalendra Singh
- Prof. Stefan Sarafianos
University of Missouri
- Prof. Thomas Klimkait
University of Basel
- Dr. Miguel E. Quinones-Mateu,
Case Western Reserve University
- Dr. Aman Russom
KTH-Scilife HIV-1C Cohorts:
- Dr. Susan Engelbrecht
- Dr. Graeme Jacobs
Stellenbosch University, South Africa
- Dr. Tasnim Azim
- Dr. Mustafizur Rahman
icddr,b
- Dr. Luke Elisabeth Hanna
National Institute of Research in Tuberculosis, India
- Dr. Amogne Wondwossen
Addis Ababa University, Ethiopia