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Cases in HIV Drug Resistance
Slide Presentation
January 20, 2010
Harry Lampiris, MD

Click on slide thumbnails to view full-size image.

Slide 1.
Cases in HIV Drug Resistance
Slide 1.
Resistance Testing in Virologic Failure
Slide 2.
Changing Treatment Goals for Treatment-Experienced Patients
Slide 3.
Antiretroviral Treatment Failure
Slide 4.
General Approaches to the Management of Virologic Failure
Slide 5.
Case 1: Patient with History of Severe Efavirenz Rash and Worsening Renal Function
Slide 6.
Case 1: Further Review of ARV History
Slide 7.
Slide 8
Slide 8.
Case 1: What Is Your Next Choice for a Regimen for This Patient as You Switch Him Off Tenofovir?
Slide 9.
How Many Active Drugs Are Needed?
Slide 10.
DUET: Combined Effect of ETR and DRV FC on Virologic Response at Week 24 (TLOVR)
Slide 11.
Etravirine Drug Interactions with Antiretrovirals
Slide 12.
DUET 1 and 2: Virologic Response (<50 copies/mL) in Etravirine Arms by BL Mutations at Week 24
Slide 13.
Updated List of Etravirine RAMs: Weight Factors for 2008 Etravirine RAMs
Slide 14.
Updated List of INTELENCE RAMs: Relationship between Weighted Score and Virologic Response
Slide 15.
ANRS 139 (TRIO Study): Combining Raltegravir, Darunavir, and Etravirine
Slide 16.
TRIO Study
Slide 17.
Proportion of Patients with HIV RNA <50 copies/mL at 48 Weeks (Missing = Failure)
Slide 18.
Back to Case 1 (continued)
Slide 19.
Etravirine Rash
Slide 20.
ETV Rash Warning: Revised Package Insert
Slide 21.
Case 2: Selecting the Best r/PI and Adding Newer Classes
Slide 22.
Slide 23
Slide 23.
Case 2: Next ARV Regimen?
Slide 24.
To Enter a Cell, HIV Uses the CD4 Receptor and a Co-Receptor, CCR5 or CXCR4
Slide 25.
Tropism in Experienced Patients as Identified by Trofile ( n = 6,857)
Slide 26.
Tropism Profile in SCOPE and HOMER Cohorts Are Influenced by CD4 Counts and by Treatment Status
Slide 27.
Sensitivity of Enhanced Trofile -- X4 Minor Variant Detection
Slide 28.
Maraviroc Drug Interactions and Dose Modifications
Slide 29.
Important Drug Interactions with Newer Agents: Tipranavir, Raltegravir, Maraviroc, and Etravirine
Slide 30.
Weighing the Mutations Associated with a Diminished Response to Darunavir
Slide 31.
TPV and DRV Mutations and Phenotypic Cutoffs
Slide 32.
r/PI Monogram Phenotype Clinical Cutoffs
Slide 33.
Updated Info on DRV and TPV Resistance Mutations
Slide 34.
Case 3: When No r/PIs Are Available or Tolerated
Slide 35.
Slide 36
Slide 36.
Case 3: Your Choice for a New Regimen Is:
Slide 37.
BRAVO Background and Baseline Characteristics
Slide 38.
Percent with VL <75 copies/mL
Slide 39.
BRAVO: Additional Results
Slide 40.
ETR + RAL PK in HIV-Negative Volunteers
Slide 41.
Case Reports: RAL Serum Concentrations When Combined with ETR
Slide 42.
NRTI- and r/PI-Sparing Salvage Regimen: RAL + MVC + ETR
Slide 43.
Superior CD4 Response in MVC Arm
Slide 44.
Case 4: Virologic Failure on Raltegravir
Slide 45.
Evolution of High-Level Integrase Inhibitor Resistance in Treatment-Experienced Patients at SFGH and SFVAMC
Slide 46.
BENCHMRK 1 & 2: Evolution from N155 to Q148 Mutations over Time
Slide 47.
Evolution of Integrase Inhibitor Resistance over Time with Detectable HIV-1 RNA
Slide 48.
Integrase Assay Accurately Determines RAL Susceptibility
Slide 49.
New ARV Choices for Salvage Therapy: Conclusions (1)
Slide 50.
New ARV Choices for Salvage Therapy: Conclusions (2)
Slide 51.

We request that all users complete the brief posttest and evaluation to provide feedback to course planners and presenters. Those requesting CME credit are required to complete all components to receive credit. Begin with the posttest.

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