CMEonHIV.com is dedicated to providing online CME presentations (slides with voiceover) on HIV/AIDS for healthcare professionals given by local and international experts to keep you up-to-date on the ongoing developments in the field.
Conference
"The Role of Abacavir in HAART" Dr. Andrew Carr (biography) English - 2004-03-29 - 70 minutes
(25 slides)
(39 slides)
Summary : In this presentation Dr Carr presents new data on the use of Abacavir in antiretroviral therapy, focusing on topics such as triple nucleoside therapy, once daily dosing, managing metabolic complications, and the resistance profiles of nucleoside analogs.
Possible advantages of triple-nuc therapy include PI/NNRTI sparing, minimal fasting requirements and improved adherence. Once-daily dosing also improves adherence and the CNA 30021 Study showed no difference in response rates, virologic failure or discontinuation due to adverse or other events with ABC OD compared to ABC BID.
The CNA 30024 Study showed the non-inferiority of ABC compared to zidovudine (ZDV) in terms of viral response rates (70%ABC vs 69%ZDV); and a significant increase in CD4+ count from baseline was observed at 48 weeks with ABC compared to ZDV.
Addition of ZDV to ABC reduced the incidence of mutations K65R and L74V (Ait-Khaled M, et al. XI Resistance, 2002: Poster 129).
The presence of HLA-B*5701 and Hsp-70-Hom M493T alleles is required for the development of ABC hypersensitivity (1); Risk factors for ABC hypersensitivity include non-Black/Hispanic race, female gender, CDC clinical stage A/B and use of HSR CRF module (GSK 24 week data).
Switching from d4T/ZDV to ABC improved lipodystrophy with a 39% increase in limb fat over 2 years (Martin et al, AIDS, in press); ABC/3TC backbone was shown to prevent loss of limb fat compared to a backbone with ddI/d4T, with a follow-up of almost 3 years (Shlay et al, 5th Lipo Workshop, 2003).
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