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

Ref.: RKI

69500 HIV-pos. ~20% female 2700 Infections/year 700 deaths/year <2% of newborns HIV-pos

Rolf Kaiser Univ Cologne Patrick Braun Robert Ehret Lab Dr. Knechten Aachen Martin Obermeier Thomas Berg Lab Dr. Berg Berlin Eva Wolf Lab Jäger Munich Christian Noah Lab Lademannbogen Hamburg Martin Däumer Lab Dr. Thiele Kaiserslautern Harm Müller Lab Fenner Hamburg Martin Stürmer

• Univ. Frankfurt

Hauke Walter Klaus Korn Univ Erlangen Alexander Thielen MPI Informatik Josef Eberle Univ Munich Claudia Kücherer Berlin