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
"Update on Resistance Profiles of Nucleoside Analogs" Prof. Mark Wainberg (biography) English - 2004-05-13 - 40 minutes
(25 slides)
Summary : One of the most important considerations when selecting a treatment regimen is preventing the development of drug resistance to preserve future treatment options. In this presentation Dr. Wainberg provides a review of the resistance data obtained from various trials testing nucleoside backbone regimens.
Resistance data obtained from the CNA 30024 study (ABC vs ZDV with 3TC and EFV) showed the presence of wild-type genotype in some failing patients, as well as primary NNRTI and M184V mutations, but no ZDV mutations such as K65R and L74V. ABC QD vs ABC BID with 3TC and EFV (CNA 30021 study) showed similar resistance profiles in both ABC study arms.
The 903 trial testing TDF vs. d4T plus EFV and 3TC also showed wild-type virus in the context of virologic failure, and it was noted that the K65R mutation which confers a broad cross-resistance appeared not alone but in combination with other mutations. The ESS30009 study which compared TDF plus ABC/3TC vs EFV plus ABC/3TC showed an unexpectedly high rate of resistance in the TDF study arm with M184V and K65R mutations, again without the K65R mutation appearing alone.
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