UK-CAB 29 – Resistance revisited

1 May 2009

At the MRC Clinical Trials Unit, 222 Euston Road, London, NW1

Programme

09:30 – 10:00 Registration, refreshments and expenses
10:00 –10:15 Welcome and introductions
10:15 – 11:00 Introducing the HIV Vaccine Advisory Board– Ken Legg, MRC and St Marys Hospital
11:00 –11:15 Break
11:15 – 12:15 Resistance Explored – Prof. Deenan Pillay, Professor of Virology, UCL and Head of HIV Group, HPA
12:15 – 12:30 Pre-meeting for GSK
12:30 – 14:00 Lunch
14:00 – 15:15 Company meeting: GSK
15:15 – 15:30 Break
15:30 – 16:00 Updates, conference feedback & UKCAB AOB
16:00 Close

Background Reading Material

Resistance

What is resistance?
Resistance to drugs occurs when the structure of a virus makes tiny changes that stops the treatment from working. These changes are called mutations.

  • You cannot develop resistance if you are not taking treatment.
  • You can be infected with a strain of HIV that is already resistant to some or all HIV drugs.

http://i-base.info/guides/changing/what-is-hiv-drug-resistance

Resistance tests

Resistance tests can show which drugs you have developed resistance to and which drugs are unlikely to work.

UK treatment guidelines recommend that everyone changing treatment should have a resistance test.

You generally need to have a viral load over 500-1000 copies/mL to produce a reliable result. You also need to have blood taken while you are still using your failing combination.

http://i-base.info/guides/changing/important-monitoring-tests

Swiss study finds moderate drug resistance; highlights difficulty of interpreting trends in changing treatment populations

Kelly Safreed-Harmon, Monday, March 16, 2009

A study published in the April edition of Clinical Infectious Diseases reports moderate drug resistance rates in a large Swiss cohort, while also cautioning that resistance data may be misleading if the treatment history of the population of interest is not taken into account. The cohort’s resistance level in 2007 was estimated to be 37% to 45%, much lower than that reported in some other studies.

http://www.aidsmap.com/en/news/79F5821E-1C0A-4373-B505-14E1E2566A87.asp?type=preview

HIV Resistance Testing

  • WHAT IS RESISTANCE?
  • HOW DOES RESISTANCE DEVELOP?
  • TYPES OF RESISTANCE
  • PHENOTYPIC TESTING
  • GENOTYPIC TESTING
  • VIRTUAL PHENOTYPE
  • CROSS RESISTANCE
  • PROBLEMS WITH RESISTANCE TESTING

http://www.aidsinfonet.org/fact_sheets/view/126

Treatment Adherence: Still Important

People who regularly miss doses of their antiretroviral (ARV) regimen have an increased risk of death, according to a study published in the April issue of the Journal of Acquired Immune Deficiency Syndromes.

When combination ARV therapy was introduced in 1995 and 1996, it quickly became clear that a person’s ability to take all of his or her doses as prescribed was vital to the regimen’s success. Studies of patient adherence found that anything less than 95 percent of doses taken correctly substantially increased the risk of treatment failure and the development of drug resistance. More recently, however, some researchers have questioned whether the more potent and tolerable regimens available today may require less strict adherence.

http://www.poz.com/printView.php?page=/articles/hiv_adherence_treatment_761_
16360.shtml&domain=www.poz.com

Financial support

The UK-CAB receives unrestricted funding from some pharmaceutical companies towards the direct costs of holding four meetings each year. This funding supports the travel and accommodation costs for members to attend from outside London, plus the cost of catering.

The content, programme and agenda for meetings is decided by the UK-CAB steering group in consultation with the wider membership. Funding is unconnected to meeting content.

We believe that manufacturers who currently develop and market medicines have a responsibility to actively engage with advocacy organisations and that HIV positive people and their advocates should be able to directly question manufacturers about the safety and efficacy of their products and proposals for future research.

For a list of companies that support the UK-CAB please see the “about us” page.

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Published: May 1, 2009
Last edited: August 13, 2013