AEGiS-14IAC: Outcome of baseline viral resistance testing in newly diagnosed human immunodeficiency virus infected patients.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Outcome of baseline viral resistance testing in newly diagnosed human immunodeficiency virus infected patients.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10177)

Harry TC, Karas A, Elumogo NT, Loveday C
Bure Clinic, James Paget Hospital, Great Yarmouth, United Kingdom

BACKGROUND: Benefit has been shown in the utility of viral resistance testing in virological failure. Primary resistance to most classes of antiretroviral drugs is now increasingly reported. The aim of this study was to evaluate the outcome of viral resistance testing in newly diagnosed HIV/AIDS patients seen from 1/1/2000 to 31/12/2001 in our centre.

METHODS: Retrospective study of computer-aided retrieval of new cases of HIV/AIDS diagnosed during the study period. The Bure Clinic is sited in a 520-bed hospital serving a population of 220,000 in rural East Anglia, England. Genotypic viral resistance testing was done using the Trugene HIV-1 Resistance (Visible Genetics).

RESULTS: There were 10 new cases of HIV/AIDS diagnosed during this period infected with HIV-1. There were 3 females, median age 25 years (range 25 -41) - 2 Africans & 1 Thai - and 7 white males median age 50 years (range 33 - 55) one of whom was homosexual. There were 4 cases of asymptomatic HIV infection (1 female & 3 males), 1 symptomatic HIV infection (male) and 5 cases of AIDS (2 females & 3 males). There were 2 cases of AZT (codon 215) associated mutations and 1 case of resistance to all NNRTI due to mutation in codon (A98A/S). Primary resistance was more likely to be seen in those with advanced disease 60% (3/5) in our small cohort but this was not overall statistically significant (p = 0.11). Thirty percent (3/10) of our cohort had primary resistance to reverse transcriptase class of antiretroviral drugs and none to protease inhibitors. The median baseline viral load in the 5 patients with advanced disease was 701,520 HIV RNA copies per ml and the median CD4 count was 88. One female died after 10 months.

CONCLUSION: In our centre we have found baseline viral resistance testing helpful in initial choice of therapy. Seventy five percent (3/4) of the advanced AIDS patients now have viral load < 1000 HIV RNA copies per ml of whom 50% (2/4) have < 50 copies HIV RNA copies per ml.

Keywords: AEGIS, Viral Load, HIV-1, HIV Infections, CD4 Lymphocyte Count, Acquired Immunodeficiency Syndrome, Zidovudine, HIV-1 Reverse Transcriptase, Research Design, Glass Ionomer Cements, Mutation, Retrospective Studies, England, BaseLine, Human, Male, Female, genetics

020707
B10177