13th Annual Conference of the British HIV Association 29 March–1 April 2007, Brighton, UK

TIME TRENDS IN HIV DRUG RESISTANCE IN ART-EXPERIENCED PATIENTS IN THE UK: IMPACT OF IMPROVED TREATMENTS AND BOOSTED PROTEASE INHIBITORS

HIV Med 2007; 8(Suppl. 1):1 (abstract no. O2)

David Dunn, Hannah Green and Esther Fearnhill
MRC Clinical Trials Unit, London, UK

AIM/OBJECTIVE: To describe time trends and drug class-specific differences in drug resistance in ART-experienced individuals in the UK.

METHODS: Data derived from the UK HIV Drug Resistance Database, representing >95% results generated in the UK. Resistance defined as ≥1 IAS-USA (2006) major mutation.

RESULTS: A total of 7794 patients were identified with one or more resistance tests. When considering one test per person per year, prevalence of any resistance remained constant from 1998–2002 (72–80%) but fell to 52% by 2005 (P<0.001). The prevalence of PI resistance decreased steadily from 35% in 1998 to 13% in 2005 (P<0.001). Triple class resistance decreased from 15% in 2002 to 6% in 2005. When using a model of cumulative resistance over time (multiple test) and as a proportion of ALL ART-treated patients in the UK (estimated from SOPHID), overall prevalence of resistance remained stable between 2000 (17.1%) and 2005 (18.4%). PI resistance fell from 8.1 to 6.2% over this period, although NRTI and NNRTI resistance remained stable. Triple class resistance fell from 4.9% in 2000 to 3.6% by end-2005, although still representing a total of 1104 individuals at this latter time point.

CONCLUSION:Our data are compatible with improvements in long-term viral suppression on ART. In particular the significant reductions in PI resistance parallel the introduction of boosted PI use. There remain >1000 patients with triple class resistance, requiring new generation drugs within existing classes, and new classes of drugs. However, this is a diminishing proportion of treated individuals, and we suggest that the potential benefit of these drugs be extended to patients outside of the MDR HIV-1 group.

2007-03-29
O2

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