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)

• nly.
• 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