Abstract

The XV International HIV Drug Resistance Workshop recorded advances in basic and clinical science of HIV resistance to antiretrovirals as well as new findings on resistance by hepatitis B virus (HBV) and hepatitis C virus (HCV). In the clinical arena, attendees learned of four cases of resistance to lopinavir/ritonavir monotherapy, correlation between low-frequency pretreatment mutations and failure of a first antiretroviral regimen, emergence of non-nucleoside-related mutations in 20% of patients interrupting a suppressive nonnucleoside regimen, and evolution of mutations conferring resistance to an HIV entry inhibitor that is being studied as a vaginal microbicide. New data reported from the POWER 1, 2 and 3 salvage trials suggested that there is a close correlation between darunavir (TMC114) phenotypic susceptibility, the number of baseline protease inhibitor-related resistance mutations and virological response. Scientists exploring the mechanisms of resistance reported of mutations in the carboxy-terminal domain of reverse transcriptase that may further resistance to zidovudine, novel mutations that may contribute to resistance of both nucleoside and non-nucleoside reverse transcriptase inhibitors, and a mechanism that HCV and HIV may share to resist antiviral therapy.

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