Josef Eberle Update 2017
HIV-Grade Tools HIV-1 HIV-2 • NNRTI • -- • NRTI • NRTI • PI • PI • Fusion (gp41) • -- • InSTI • InSTI • [Coreceptor geno2pheno] • [Coreceptor geno2pheno] HBV HCV with geno2pheno
Pt with haemophilia, 58y, from 1985 HIV-1B, HCV 1989-2015
.. still left some PIs, InSTIs, and the CCR5 antagonist
Rules set • Based on – publications – treatment observations – phenotypic lab tests • Two updates per year • Differentiated set of ≈ 300 rules
Regular up dates for algorithms • e.g. Doravirin Which significance have special mutations or their combinations – V106A/M – Y188L – G190A – H221Y – F227L/C – L234I
A small glance into the NNRTI world K103 V106 Y181 181 Y188 Y188 Y188 G190 G190 H221 F227 M230 L234 NHST A C IV L C H ACEQS TV Y C L I EFV ETR NVP RPV
Work in progress on InSTI algorithms • For DTG, EVG, RAL What is the significance of single mutations or combinations of V260I R263K
What significance have revertants? here for ABC: M41L, L210W with T215S
HIV-2 • Work on treatment guidelines in cooperation with German/European professional societies (see presentation by Dirk Berzow) • Develop and adjust rules for resistance algorithms (see presentation by Martin Obermeier)
How to handle this HIV-2 case: Afrikan , 55y, 8.300 IU/ml..
No mutations for InSTIs, two amplicons for the coreceptor region 1. with primerset A (weak band)
2. with primerset B (strong band)
In Summary Not much left for therapy. HIV-2 is different at some points. Plan therapy carefully.
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