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HIV-1 Reverse Transcriptase Thymidine Analogue Resistance

Poster No TUPDA 205 XVII International AIDS Conference 2008. HIV-1 Reverse Transcriptase Thymidine Analogue Resistance. Mutation Pattern among the HIV-1 Infected. South Indian Patients. Vidya M YRG CARE. BACKGROUND & OBJECTIVE.

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HIV-1 Reverse Transcriptase Thymidine Analogue Resistance

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  1. Poster No TUPDA 205 XVII International AIDS Conference 2008 HIV-1 Reverse Transcriptase Thymidine Analogue Resistance Mutation Pattern among the HIV-1 Infected South Indian Patients Vidya M YRG CARE

  2. BACKGROUND & OBJECTIVE • AZT/d4T, 3TC and NVP/EFV is widely available, inexpensive generic regimen in India. • Monitoring patients for IF/CF in developing countries is likely to mean that patients will experience virological failure (VF) on thymidine analogues for a prolonged period • To analyze the pattern of resistant mutations among patients failing first-line HAART Gallant JE, 2007, Sungkanuparph et al., 2007

  3. MATERIALS AND METHODS • 350 - IF to first-line regimens ; 326 (AZT/d4T+3TC+NVP/EFV) • Group A n=179 Group B n=171 • Homebrew genotyping (Boden et al., 1999 and Larder et al., 1991) http://hivdb.stanford.edu/hiv, accessed on 21 January 2008. • TAM1 (41L, 210W, 215Y) and TAM2 (67N, 70R, 215F, 219E/Q) • Chi-square tests and student’s t-test

  4. Demographics and Clinical history (n=350)

  5. RT Resistance Mutations (n=326)

  6. Selection of TAMs among patients failing first-line regimen containing thymidine analogue (n=326)

  7. Selection of TAMs pathway with respect to AZT/d4T exposure (n=326)

  8. SUMMARY AND CONCLUSION TAMs – second most predominant (62%) next to M184V. TAM 1 pathway was significantly (p<0.05) selected among mono/dual exposed When thymidine analogues were used, NRTI cross resistance could be prevented by identifying early virological failure and modifying therapy, thus easier to design fully suppressive second-line regimen after treatment failure

  9. THANKS

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