UK-CAB 29 – Resistance revisited
1 May 2009
At the MRC Clinical Trials Unit, 222 Euston Road, London, NW1
Programme
09:30 – 10:00 | Registration, refreshments and expenses |
10:00 –10:15 | Welcome and introductions |
10:15 – 11:00 | Introducing the HIV Vaccine Advisory Board– Ken Legg, MRC and St Marys Hospital |
11:00 –11:15 | Break |
11:15 – 12:15 | Resistance Explored – Prof. Deenan Pillay, Professor of Virology, UCL and Head of HIV Group, HPA |
12:15 – 12:30 | Pre-meeting for GSK |
12:30 – 14:00 | Lunch |
14:00 – 15:15 | Company meeting: GSK |
15:15 – 15:30 | Break |
15:30 – 16:00 | Updates, conference feedback & UKCAB AOB |
16:00 | Close |
Background Reading Material
Resistance
What is resistance?
Resistance to drugs occurs when the structure of a virus makes tiny changes that stops the treatment from working. These changes are called mutations.
- You cannot develop resistance if you are not taking treatment.
- You can be infected with a strain of HIV that is already resistant to some or all HIV drugs.
http://i-base.info/guides/changing/what-is-hiv-drug-resistance
Resistance tests
Resistance tests can show which drugs you have developed resistance to and which drugs are unlikely to work.
UK treatment guidelines recommend that everyone changing treatment should have a resistance test.
You generally need to have a viral load over 500-1000 copies/mL to produce a reliable result. You also need to have blood taken while you are still using your failing combination.
http://i-base.info/guides/changing/important-monitoring-tests
Swiss study finds moderate drug resistance; highlights difficulty of interpreting trends in changing treatment populations
Kelly Safreed-Harmon, Monday, March 16, 2009
A study published in the April edition of Clinical Infectious Diseases reports moderate drug resistance rates in a large Swiss cohort, while also cautioning that resistance data may be misleading if the treatment history of the population of interest is not taken into account. The cohort’s resistance level in 2007 was estimated to be 37% to 45%, much lower than that reported in some other studies.
http://www.aidsmap.com/en/news/79F5821E-1C0A-4373-B505-14E1E2566A87.asp?type=preview
HIV Resistance Testing
- WHAT IS RESISTANCE?
- HOW DOES RESISTANCE DEVELOP?
- TYPES OF RESISTANCE
- PHENOTYPIC TESTING
- GENOTYPIC TESTING
- VIRTUAL PHENOTYPE
- CROSS RESISTANCE
- PROBLEMS WITH RESISTANCE TESTING
http://www.aidsinfonet.org/fact_sheets/view/126
Treatment Adherence: Still Important
People who regularly miss doses of their antiretroviral (ARV) regimen have an increased risk of death, according to a study published in the April issue of the Journal of Acquired Immune Deficiency Syndromes.
When combination ARV therapy was introduced in 1995 and 1996, it quickly became clear that a person’s ability to take all of his or her doses as prescribed was vital to the regimen’s success. Studies of patient adherence found that anything less than 95 percent of doses taken correctly substantially increased the risk of treatment failure and the development of drug resistance. More recently, however, some researchers have questioned whether the more potent and tolerable regimens available today may require less strict adherence.
Financial support
The UK-CAB receives unrestricted funding from some pharmaceutical companies towards the direct costs of holding four meetings each year. This funding supports the travel and accommodation costs for members to attend from outside London, plus the cost of catering.
The content, programme and agenda for meetings is decided by the UK-CAB steering group in consultation with the wider membership. Funding is unconnected to meeting content.
We believe that manufacturers who currently develop and market medicines have a responsibility to actively engage with advocacy organisations and that HIV positive people and their advocates should be able to directly question manufacturers about the safety and efficacy of their products and proposals for future research.
For a list of companies that support the UK-CAB please see the “about us” page.