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

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May 04, 2023 376 likes •559 views

HIV-2 Resistance Interpretation and Case Report PD Dr. Martin Strmer 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

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HIV-2 Resistance Interpretation and Case Report

PD Dr. Martin Stürmer Institute for Medical Virology University Clinic Frankfurt/Main

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HIV-2 Wildtype

What happens, if you submit the HIV-2

wildtype sequence ROD to online-tools for interpretation of HIV drug resistance?

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HIV-2 Wildtype

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HIV-2 Wildtype

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HIV-2 Wildtype

And where is the Protease???

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HIV-2 Wildtype

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HIV-2 Wildtype

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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

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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???

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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

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1 10 100 1.000 10.000 100.000 Sep. 00 May. 03 Dez. 03 Dez. 04 Sep. 05 Feb. 07 Jul. 07 Jan. 08 Sep. 08 Apr. 09 H I V R N A [ K

i e n / m l ] 200 400 600 800 C D 4 [ Z e l l e n / µ l ]

< 100

AZT AZT 3TC 3TC TDF TDF FTC FTC LPV/r LPV/r

Case Report

Adverse Event: high blood fat values

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1 10 100 1.000 10.000 100.000 Sep. 00 May. 03 Dez. 03 Dez. 04 Sep. 05 Feb. 07 Jul. 07 Jan. 08 Sep. 08 Apr. 09 H I V R N A [ K

i e n / m l ] 200 400 600 800 C D 4 [ Z e l l e n / µ l ]

< 100

AZT AZT 3TC 3TC TDF TDF FTC FTC LPV/r LPV/r

Case Report

Resistance Test

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Discussion

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1 10 100 1.000 10.000 100.000 Sep. 00 May. 03 Dez. 03 Dez. 04 Sep. 05 Feb. 07 Jul. 07 Jan. 08 Sep. 08 Apr. 09 H I V R N A [ K

i e n / m l ] 200 400 600 800 C D 4 [ Z e l l e n / µ l ]

< 100

AZT AZT 3TC 3TC TDF TDF FTC FTC LPV/r LPV/r DRV/r DRV/r SQV/r SQV/r RAL RAL