Correlation of HIV tropism with immunological response under HAART - - PowerPoint PPT Presentation

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Correlation of HIV tropism with immunological response under HAART - - PowerPoint PPT Presentation

May 11, 2023 7 likes •140 views

Correlation of HIV tropism with immunological response under HAART Jolle Bader Thomas Klimkait May 4 th 2012 Department Biomedicine University of Basel Viral load vs. CD4 recovery under HAART 500 CD4 cells/mL Kaufmann et al; AIDS

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Joëlle Bader Thomas Klimkait

Correlation of HIV tropism with immunological response under HAART

May 4th 2012 Department Biomedicine University of Basel

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Kaufmann et al; AIDS 2008,41:361-372

Viral load vs. CD4 recovery under HAART

500 CD4 cells/mL

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Does X4 lead to poor CD4 recovery or does a low response cause X4?

X4 tropism at baseline correlates with more rapid progression

[Weiser et al; AIDS 2008,22:469-479]

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500 CD4 cells/mL

Kaufmann et al; AIDS 2008,41:361-372

Viral load vs. CD4 recovery under HAART

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  • n = 67 patients
  • Under HAART for >3 years, (no maraviroc involved)
  • All show full viral response < 20 c/mL
  • CD4 cells > 500 /mL after 3-5 years = no plateau

n = 35 patients

  • CD4 cells < 500 /mL after 3-5 years = plateau

n = 32 patients

  • Tropism determination (XTrack) around time of HAART

initiation

Study characteristics

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SLIDE 6

XTrack system

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69 % 21 % 10 %

Tropism in the study population analyzed by XTrack

Results

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21 % 24 % 76 % 69 % 21 % 10 %

Results

Tropism in the study population by XTrack / G2P

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30 % 76 % 58 % 12 % 24 %

Tropism in the study population by XTrack / G2P

Results

67 patients  11 cases (16%) discordance between XTrack/G2P 3/4 phenotypes agree with XTrack

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SLIDE 10

Results

62 % 39 % 25 % 75 %

Continuous response vs. plateau

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62 % 39 % 25 % 75 % 29 % 71 % 43 % 57 % 50 % 50 %

Continuous response vs. plateau

Results

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SLIDE 12

Results

Comparison of different FPR cutoff’s

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  • Early X4 use predicts poor CD4 recovery
  • Tropism test older than 3 years is predictive (despite viral response)
  • XTrack is superior for mixed populations

? Does drug pressure play a role (PI vs. NNRTI)? ? Which role do viral minorities play? ? Is there clinical utility of our data for the use of MVC? ? Does G2P classify too many R5 viruses as X4-tropic?

Conclusion and outlook