Low viral load treat it or tolerate it? Hauke Walter Erlangen - PowerPoint PPT Presentation

Low viral load – treat it or tolerate it? Hauke Walter Erlangen

News from HIV-GRADE • Algorithms for NRTI, NNRTI, PI, IN without relevant changes • Combination tool for NRTIs under investigation – Decreasing Role of NRTIs – Implementation of other drug classes in progress • HIV-2 resistance tool developed – Clinical validation in progress (R. Camacho, J. Eberle) • Implementation of HIV-GRADE in CHAIN

Studies • Comparison of coreceptor tropism testing performed form plasma RNA and proviral DNA – First results presented in Paphos – Final results will be presented at DÖAK and International HIV and Hepatitis WS 2011 • Subtyping and coreceptor tropism determination by g2p

Plans • HCV resistance prediction tool • Extension of HIV-GRADE database – At the moment used for storing V3-loop sequence data for HIV-GRADE studies – Open database system planned for optional storing and retrieving anonymous sequence data with every interpretation performed by the HIV-GRADE tools

Project: Influence of low viral load on resistance detection • Observed for pts with 20<VL<200 – A: Crossectional retrospective design – B: Longitudinal design • Aims: – At which viral load resistance testing is meaningful ? • Can clinically relevant resistance be detected ? • Role of BL resistance (new mutation vs any mutation relevant to acutsl ART) • How relevant are VL dynamics (at first confirmed detectable VL vs. at any time with detctable VL) ?

Conclusion • Low VL is the main observation during failure • Currently <50 is the cut-off supported by experience • More data is needed to investigate which VL level may be the best

members Christian Noah Rolf Kaiser 69500 HIV-pos. Lab Lademannbogen Univ Cologne Hamburg ~20% female Patrick Braun 2700 Infections/year Harm Müller Robert Ehret Lab Fenner 700 deaths/year Lab Dr. Knechten Hamburg <2% of newborns HIV-pos Aachen Claudia Kücherer Martin Däumer Berlin Lab Dr. Thiele Kaiserslautern Martin Obermeier Thomas Berg Alexander Thielen Lab Dr. Berg MPI Informatik Berlin Martin Stürmer Hauke Walter Univ. Frankfurt Klaus Korn Univ Erlangen Eva Wolf Josef Eberle Lab Jäger Ref.: RKI Univ Munich Munich