Transmission Fitness of Drug- Resistant HIV Revealed in the United States National Surveillance System
|
|
- Madeline Henderson
- 5 years ago
- Views:
Transcription
1 Transmission Fitness of Drug- Resistant HIV Revealed in the United States National Surveillance System Joel O. Wertheim 1,2, Alexandra M. Oster 3, Jeffrey A. Johnson 3, William M. Switzer 3, Neeraja Saduvala 2, Angela L Hernandez 3, H. Irene Hall 3, Walid Heneine 3 1 Department of Medicine, University of California, San Diego, CA 2 ICF International, Atlanta, GA 3 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of HIV/AIDS Prevention
2 Fitness consequences of drug resistance associated mutations (DRAMs) Anti-retroviral therapy (ART) has been hugely successful in combating HIV/AIDS DRAMs confer resistance to ART and a fitness advantage in the presence of drug In the absence of drug, DRAMs reduce replicative fitness and persistence to varying degrees High cost: M184V, K65R, T215Y Low cost: K103N, Y181C, D67N, L210W Fitness cost highly dependent on genetic background and can be enhanced or decreased by additional DRAMs 1 1 Pingen (2014) Retrovirology
3 Fitness consequences of drug resistance associated mutations (DRAMs) Replicative fitness affects transmission Direct evidence in macaque models of lower rectal and vaginal transmission of SHIV-M184V and SHIV-K65R 1 Requires higher concentration needed to transmit DRAMs are transmitted 80% less often than would be expected 2 Population level analysis has compared prevalence of DRAMs in ART-naïve and ART-experienced persons 1 Cong et al. (2013) JID, Cong et al. (2011) Virology, Cong et al. (2011) J Virol 2 Leigh Brown et al. (2003) JID
4
5
6 Fitness consequences of drug resistance associated mutations (DRAMs) Specific DRAM fitness estimates are not consistent between studies E.g., L90M fitness estimate is lower in Spain than Portugal/Germany 1 Winland et al. find differences for fitness effects among classes 1 Outlier approach can estimate fitness differences only among DRAMs, not to wild-type virus We sought a more direct measurement of DRAM fitness Avoid confounding effect of naïve to experienced comparison o Behavioral change, effect of ART, and duration of infection 1 Winland et al. (2015) AIDS; de Mendoza et al. (2004) CID
7 How do DRAMs affect transmission fitness? Are DRAMs persistent within transmission clusters over many years?
8 Dataset HIV-1 Genetic Transmission Network 66,235 HIV-1 pol sequences (pr/rt) reported to the US National HIV Surveillance System for persons diagnosed through 2012 o Subtypes: A, B, C, D, F, G, CRF01_AE, and CRF02_AG o Earliest sequence ( 500 nt) from each person was used 30,200 collected within 3 months of diagnosis in ART-naïve persons (i.e., no evidence of prior ART use) DRAMs were characterized using Sierra 17% (5,127/30,196) of ART-naïve persons have 1 DRAM 1 CDC Mutation List, found in Wheeler et al. (2010) AIDS
9 HIV-1 Genetic Transmission Network Network Construction 1 Pairwise alignment to HXB2 Excised codons associated with drug resistance 2 Determined potential transmission partners: persons whose sequences were 1.5% TN93 genetic distance apart Identified ART-naïve persons who were potential transmission partners with other ART-naïve persons Network Features Inferred 5343 clusters with 2 people 21,106/66,235 (31.9%) were clustered 212 of clusters with 4 people with evidence of transmitted drug resistance (TDR: shared DRAMs between potential transmission partners) in at least 1/3 of cluster members 1 Wertheim et al. (2014) JID 2 CDC Mutation List, found in Wheeler et al. (2010) AIDS
10 Transmission network of clusters with TDR ART-naïve ART-experienced ART unknown Non-TDR genetic link TDR genetic link
11 HIV-1 Genetic Transmission Network Interhost Fitness Measurement (in ART-naïve persons) Do strains containing DRAMs cluster in the network more often than strains lacking DRAMs? Relative fitness = clustering frequency of DRAM strains/clustering frequency of non-dram strains The deviation from expected clustering frequency can be expressed using c 2 However, there is a non-independence issue, because mutations tend to be shared across clusters Difficult to disentangle fitness effects due to DRAMs from cluster growth 1 Wertheim et al. (2014) JID 2 CDC Mutation List, found in Wheeler et al. (2010) AIDS
12 HIV-1 Genetic Transmission Network Interhost Fitness Measurement (in ART-naïve persons) Need clustering frequency for neutral markers for comparison Calculated c 2 for 367 minority synonymous variants ( 2.0%) to construct a null expectation for deviation in clustering frequency Is the clustering frequency of DRAM strains more extreme than would be expected for a synonymous variant? Due to conservative nature of test, we report p < 0.10 Count c 2 value
13 Effect of DRAM classes on clustering (transmission) in ART-naïve persons in the network Class Effect Number clustering Percentage clustering p-value All ART-naïve 11,692/30, % All DRAMs None 1951/ % NRTI DRAMs Decrease 645/ % PI DRAMs None 552/ % NNRTI DRAMs Increase? 1080/ % DRAMs as a whole do not affect clustering frequency
14
15
16
17
18
19
20
21 Large clusters with evidence of TDR Large clusters with TDR ( 20 persons, 33% TDR) Members of these 15 clusters did not significantly differ from those in the 65 largest non-tdr clusters ( 20 persons) with respect to sex, race/ethnicity, or transmission category. Molecular Dating 1 Largest DRAM clusters were analyzed using molecular clock dating analysis in BEAST v Estimate time of most recent common ancestor of clusters and properly root phylogenetics trees Explored how DRAMs were maintained or lost through time within transmission clusters 1 Drummond et al. (2012) MBE
22 L90M persistence since introduction of saquinavir E ART experienced; * Posterior Probability 0.90
23 L90M persistence since introduction of saquinavir E ART experienced; * Posterior Probability 0.90
24 Y181C persistence over 8 years E ART experienced; * Posterior Probability 0.90
25 K103N persistence and reversion to wild type E ART experienced; * Posterior Probability 0.90
26 K103N persistence and onward mutation to K103S E ART experienced; * Posterior Probability 0.90
27 K103N persistence and reversion to wild type E ART experienced; * Posterior Probability 0.90
28 TMRCA time of most recent common ancestor
29 Observations Transmission networks offer opportunity to explore interhost fitness consequences of DRAMs Some strains containing major DRAMs were equivalent to or exceeded the fitness of wild-type variants in the US population L90M, K103N Y181C, V11I, T74S, K103S Correcting for clustering effect in the network can be achieved using synonymous variants
30 Clinical implications Most high frequency mutations likely originated from earlier drug exposures and often are secondary revertant mutations L90M (saquinavir), D67N (AZT/d4T), T215D (AZT/d4T) TMRCA of L90M clusters aligns with introduction of saquinavir Not likely to affect treatment efficacy for current first line treatments K103N is an exception to this pattern Transmission fitness equal to or greater than synonymous variants Compensatory mutations likely allow increased fitness 1 Provides nevirapine and efavirenz resistance, still relevant 1 Pingen (2014) Retrovirology
31 Clinical implications (cont.) Persons who are ART-experienced and have DRAMs may have acquired these DRAMs via TDR ART-experienced people are not basal in phylogenies of large clusters with evidence of TDR DRAMs that could diminish current PrEP regimen are infrequently transmitted M184V had a relative fitness of 0.73 (p =0.022) K65R had a relative fitness of 0.66 (p =0.28) Reassuring that if drug-resistant strains arise from PrEP use, they are unlikely to be propagated
32 Conclusions The vast majority of DRAMs do not have detectable fitness consequences Some DRAMs have a propensity to propagate, but it is likely highly contingent on the mutation, genetic background, and US population environment In some cases, strains containing DRAMs have exceeded wild-type fitness We are still seeing the effect of drugs used over a decade ago
33 Thanks to Ben Murrell for statistical advice, state and local Health departments, and an NIH-NIAID K01 award to JOW. For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA Telephone: CDC-INFO ( )/TTY: Visit: Contact CDC at: CDC-INFO or The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of HIV/AIDS Prevention
Use of molecular surveillance data to identify clusters of recent and rapid HIV transmission
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Use of molecular surveillance data to identify clusters of recent and rapid HIV transmission Alexa Oster, MD Acting Lead, Incidence
More informationImpact of ART resistance in sub Saharan Africa
Impact of ART resistance in sub Saharan Africa Elliot Raizes, MD Division of Global HIV/TB US Centers for Disease Control and Prevention ITREMA Resistance Training Workshop 24 October, 2018 Center for
More informationDetecting HIV transmission clusters to better prioritize prevention efforts
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Detecting HIV transmission clusters to better prioritize prevention efforts Alexa Oster, MD Lead (Acting), Transmission and Molecular
More informationMortality Slide Series. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of HIV/AIDS Prevention
Mortality Slide Series National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of HIV/AIDS Prevention HIV Mortality Slides An analysis of trends in rates and distributions of deaths
More informationPharmacokinetic and pharmacodynamic profile of maraviroc in rhesus macaques after a single oral dose
HIV Transmission Workshop 011 Pharmacokinetic and pharmacodynamic profile of maraviroc in rhesus macaques after a single oral dose Wutyi Aung, Amy Martin, Mian-er Cong, Jessica Radzio, Elizabeth Sweeney,
More informationClinical and Behavioral Characteristics of HIV-infected Young Adults in Care in the United States
Clinical and Behavioral Characteristics of HIV-infected Young Adults in Care in the United States Linda Beer, PhD, Christine L. Mattson, PhD, Joseph Prejean, PhD, and Luke Shouse, MD 10 th International
More informationResistance Workshop. 3rd European HIV Drug
3rd European HIV Drug Resistance Workshop March 30-April 1 st, 2005 Christine Hughes, PharmD Clinical Associate Professor Faculty of Pharmacy & Pharmaceutical Sciences University of Alberta Tenofovir resistance
More informationPRINCIPLES and TRENDS in MANAGEMENT of HIV DISEASE: PROBLEMS OF DRUG RESISTANCE in VIRUSES of DIFFERENT SUBTYPES
PRINCIPLES and TRENDS in MANAGEMENT of HIV DISEASE: PROBLEMS OF DRUG RESISTANCE in VIRUSES of DIFFERENT SUBTYPES Mark A. Wainberg McGill University AIDS Centre Jewish General Hospital Montreal, Quebec,
More informationHIV-1 Subtypes: An Overview. Anna Maria Geretti Royal Free Hospital
HIV-1 Subtypes: An Overview Anna Maria Geretti Royal Free Hospital Group M Subtypes A (1, 2, 3) B C D F (1, 2) G H J K Mechanisms of HIV-1 genetic diversification Point mutations RT error rate: ~1 per
More informationReverse transcriptase and protease inhibitor resistant mutations in art treatment naïve and treated hiv-1 infected children in India A Short Review
pissn 2349-2910 eissn 2395-0684 REVIEW Reverse transcriptase and protease inhibitor resistant mutations in art treatment naïve and treated hiv-1 infected children in India A Short Review Dinesh Bure, Department
More informationInfluenza Surveillance in the United St ates
Influenza Surveillance in the United St ates Scot t Epperson, MPH Surveillance and Outbreak Response Team Influenza Division U.S. Centers for Disease Control and Prevention National Center for Immunization
More informationDr Carole Wallis, PhD Medical Director, BARC-SA Head of the Specialty Molecular Division, Lancet Laboratories, South Africa
Dr Carole Wallis, PhD Medical Director, BARC-SA Head of the Specialty Molecular Division, Lancet Laboratories, South Africa Transmitted drug resistance Resistance patterns in first-line failures in adults
More informationAddressing HIV among Hispanic/Latino MSM
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of HIV/AIDS Prevention Addressing HIV among Hispanic/Latino MSM Eugene McCray, M.D. Director, Division of HIV/AIDS Prevention
More informationPrevalence of Transmitted Drug Resistance Mutations among Naive HIV-infected patients ( ) in Northwest Spain
Prevalence of Transmitted Drug Resistance Mutations among Naive HIV-infected patients (2014-2016) in Northwest Spain Berta Pernas 1, Andrés Tabernilla 1, Marta Grandal 1, Angelina Cañizares 2, Sofía Ortún
More informationManagement of NRTI Resistance
NORTHWEST AIDS EDUCATION AND TRAINING CENTER Management of NRTI Resistance David Spach, MD Principal Investigator, NW AETC Professor of Medicine, Division of Infectious Diseases University of Washington
More informationHIV Drug Resistance among Adolescents and Young Adults Failing HIV Therapy in Zimbabwe
HIV Drug Resistance among Adolescents and Young Adults Failing HIV Therapy in Zimbabwe V Kouamou 1, J Manasa 1, D Katzenstein 1, A McGregor 1, CE Ndhlovu 1 & AT Makadzange 1. 1 University of Zimbabwe Introduction
More informationZika Virus Communication Media Talking Points
Zika Virus Communication Media Talking Points Benjamin Haynes Senior Press Officer, News Media Branch, CDC Department of Health and Human Services Centers for Disease Control and Prevention Media Talking
More informationSexually Transmitted Disease Prevention
Sexually Transmitted Disease Prevention April 13, 2016 Dr. Gail Bolan Director, Division of STD Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Overview of Discussion STDs:
More informationWhat s New in Acute HIV Infection?
3 4 Disclosure I have received research grants awarded to my institution from Gilead Sciences, Inc. ntiretroviral medications have been provided by Gilead Sciences, Inc. Susan Little, M.D. Professor of
More informationFollow-up investigation of a cluster of treatment-naïve HIV-infected patients with multi-drug resistance in Sudbury, Ontario
Follow-up investigation of a cluster of treatment-naïve HIV-infected patients with multi-drug resistance in Sudbury, Ontario Ashleigh Sullivan, Penny Sutcliffe, Roger Sandre, P. Richard Harrigan, Chris
More informationSocio-Demographic Factors associated with Success of Antiretroviral Treatment among HIV Patients in Tanzania
Socio-Demographic Factors associated with Success of Antiretroviral Treatment among HIV Patients in Tanzania Dr. Fausta Franklin Mosha (MD, MSc, MSc, PHD) Ministry of Health and Social Welfare 22 nd October
More informationHistory (August 2010) Therapy for Experienced Patients. History (September 2010) History (November 2010) 12/2/11
(August 2010) Therapy for Experienced Patients Hiroyu Hatano, MD, MHS Assistant Professor of Medicine University of California San Francisco Medical Management of AIDS December 2011 42M HIV (CD4=450, VL=6250,
More informationCouncil for Outbreak Response: Healthcare-Associated Infections & Antibiotic-Resistant Pathogens (CORHA) HICPAC December 1, 2016
Council for Outbreak Response: Healthcare-Associated Infections & Antibiotic-Resistant Pathogens (CORHA) HICPAC December 1, 2016 National Center for Emerging and Zoonotic Infectious Diseases Division of
More informationTrends in HIV Incidence and Prevalence in the United States
Trends in HIV Incidence and Prevalence in the United States Irene Hall, PhD, FACE 7th International Workshop on HIV Transmission Washington, DC, July 20, 2012 National Center for HIV/AIDS, Viral Hepatitis,
More informationIMPLEMENTATION OF GHOST FOR HAV OUTBREAK DETECTION
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention IMPLEMENTATION OF GHOST FOR HAV OUTBREAK DETECTION Sumathi Ramachandran,MS,MPH,PHD Molecular Epidemiology and Bioinformatics Team Division
More informationSomnuek Sungkanuparph, M.D.
HIV Drug Resistance Somnuek Sungkanuparph, M.D. Associate Professor Division of Infectious Diseases Department of Medicine Faculty of Medicine Ramathibodi Hospital Mahidol University Adjunct Professor
More informationDr Marta Boffito Chelsea and Westminster Hospital, London
Dr Marta Boffito Chelsea and Westminster Hospital, London Speaker Name Statement Dr Marta Boffito has received travel and research grants from and has been an advisor for Janssen, Roche, Pfizer, ViiV,
More informationTransmission of integrase resistance HIV
Transmission of integrase resistance HIV Charles Boucher, MD, PhD Clinical Virology, Dept. Viroscience, Erasmus Medical Center, Erasmus Universiy, The Netherlands Major resistance mutations (Stanford)
More informationPS : Comprehensive HIV Prevention Programs for Health Departments
PS12-1201: Comprehensive HIV Prevention Programs for Health Departments Program Overview Erica K. Dunbar, MPH Program Leader, Health Department Initiatives National Center for HIV/AIDS, Viral Hepatitis,
More informationStepwise Process for Improving the Quality of HIV-related POCT Sites Towards Certification
Implementing Quality-Assured Point-of-Care Testing Stepwise Process for Improving the Quality of HIV-related POCT Sites Towards Certification Center for Global Health Division of Global HIV and TB*- International
More informationDoes Resistance Still Matter? Daniel R. Kuritzkes, M.D. Division of Infectious Diseases Brigham and Women s Hospital Harvard Medical School
Does Resistance Still Matter? Daniel R. Kuritzkes, M.D. Division of Infectious Diseases Brigham and Women s Hospital Harvard Medical School Disclosure The speaker serves as a consultant to, and has received
More informationCase Study. Dr Sarah Sasson Immunopathology Registrar. HIV, Immunology and Infectious Diseases Department and SydPath, St Vincent's Hospital.
Case Study Dr Sarah Sasson Immunopathology Registrar HIV, Immunology and Infectious Diseases Department and SydPath, St Vincent's Hospital Case 1: Case 1: 45F in Cameroon Cameroon HIV+ Presents with cutaneous
More informationThe new epidemic of drug resistant HIV-1
The new epidemic of drug resistant HIV-1 Gillian Hunt Centre for HIV and STI National Institute for Communicable Diseases ICREID March 2018 Status of the global HIV epidemic (2016) WHO Global Summary on
More informationUsing Partner Services Data to Enhance Molecular HIV Surveillance Cluster Analyses
Using Partner Services Data to Enhance Molecular HIV Surveillance Cluster Analyses Scott White, MS, MPH Epidemiology Manager Prevention, Treatment and Care Program Outline HIV in Utah Molecular HIV Surveillance
More information6/2/2014. TB among Persons Experiencing Homelessness DEFINING THE PROBLEM. Overview. Sapna Bamrah Morris, MD
TB among Persons Experiencing Homelessness Sapna Bamrah Morris, MD June 11, 2014 National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of TB Elimination Overview Defining the problem
More informationSecond-Line Therapy NORTHWEST AIDS EDUCATION AND TRAINING CENTER
NORTHWEST AIDS EDUCATION AND TRAINING CENTER Second-Line Therapy David Spach, MD Clinical Director, Northwest AETC Professor of Medicine, Division of Infectious Diseases University of Washington Presentation
More informationRound table discussion Patients with multiresistant virus : A limited number, but a remarkable deal Introduction
Disclosure statement: Dr. Santoro reports personal fees from ViiV Healthcare, Gilead and JANSSEN Cilag Round table discussion Patients with multiresistant virus : A limited number, but a remarkable deal
More informationLow-frequency HIV-1 drug resistance mutations can be clinically significant but must be interpreted with caution
J Antimicrob Chemother 2010; 65: 1322 1326 doi:10.1093/jac/dkq139 Advance Access publication 13 May 2010 Low-frequency HIV-1 drug resistance mutations can be clinically significant but must be interpreted
More informationBlack MSM, HIV, and the Social Determinants of Health Imperative
Black MSM, HIV, and the Social Determinants of Health Imperative William L. Jeffries IV, PhD, MPH, MA Research Scientist June 5, 2013 National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
More informationTransmitted antiretroviral drug resistance in a low HIV prevalence setting
University of Iowa Iowa Research Online Theses and Dissertations Summer 2012 Transmitted antiretroviral drug resistance in a low HIV prevalence setting Thuy Thi Vu Nguyen University of Iowa Copyright 2012
More informationClinical skills building - HIV drug resistance
Clinical skills building - HIV drug resistance Richard Lessells Clinical case 44-year old HIV-positive male HIV diagnosis 2010 Pre-treatment CD4+ count not known Initiated first-line ART (TDF/FTC/EFV)
More informationMapping Evolutionary Pathways of HIV-1 Drug Resistance. Christopher Lee, UCLA Dept. of Chemistry & Biochemistry
Mapping Evolutionary Pathways of HIV-1 Drug Resistance Christopher Lee, UCLA Dept. of Chemistry & Biochemistry Stalemate: We React to them, They React to Us E.g. a virus attacks us, so we develop a drug,
More informationExperience with Pyrazinamide and Rifampin Regimens for Latent TB Infection
Experience with Pyrazinamide and Rifampin Regimens for Latent TB Infection Krista Powell, MD, MPH Co-Project Officer, National Surveillance for Severe Adverse Events Associated with LTBI Treatment Lead,
More informationSexual Networks: Challenges (and Opportunities)
Sexual Networks: Challenges (and Opportunities) Susan Little, M.D. Professor of Medicine University of California San Diego 1 Network Theory What network theory teaches us is that connections, even within
More informationHIV DRUG RESISTANCE IN AFRICA
HIV DRUG RESISTANCE IN AFRICA Francis Ssali Joint Clinical Research Centre, Kampala Interest Meeting Mombasa May 10 th 2012 Scope 1. HIV-DR testing in Africa 2. The Epidemiology of HIV-DR in Africa 3.
More informationClinical utility of NGS for the detection of HIV and HCV resistance
18 th Annual Resistance and Antiviral Therapy Meeting v Professor Janke Schinkel Academic Medical Centre, Amsterdam, The Netherlands Thursday 18 September 2014, Royal College of Physicians, London Clinical
More informationHigh Impact Prevention: Science, Practice, and the Future of HIV
High Impact Prevention: Science, Practice, and the Future of HIV Jonathan Mermin, MD, MPH National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Centers for Disease Control and Prevention
More informationHepatitis B Epidemiology and Prevention in the Elimination Era John W. Ward, MD
Hepatitis B Epidemiology and Prevention in the Elimination Era John W. Ward, MD Director, Program for Viral Hepatitis Elimination, Task Force for Global Health Senior Scientist, National Center for HIV/AIDS,
More informationHIV/AIDS CID 2003:37 (1 July) 113
MAJOR ARTICLE HIV/AIDS Antiretroviral Drug Resistance Testing in Adults Infected with Human Immunodeficiency Virus Type 1: 2003 Recommendations of an International AIDS Society USA Panel Martin S. Hirsch,
More informationCDC Programmatic Activities in Breast and Ovarian Cancer Genomics
CDC Programmatic Activities in Breast and Ovarian Cancer Genomics Katrina F. Trivers, PhD, MSPH Epidemiologist Division of Cancer Prevention and Control CDC The First Line of Defense: Application of Breast
More informationUpdate on the White House Campus Sexual Assault Task Force: CDC s Efforts. Dawnovise N. Fowler, Ph.D. CDC/NCIPC Lead Behavioral Scientist
Update on the White House Campus Sexual Assault Task Force: CDC s Efforts Dawnovise N. Fowler, Ph.D. CDC/NCIPC Lead Behavioral Scientist Presented at the Safe States Annual Meeting April 30, 2015 National
More informationVirological failure to Protease inhibitors in Monotherapy is linked to the presence of signature mutations in Gag without changes in HIV-1 replication
Virological failure to Protease inhibitors in Monotherapy is linked to the presence of signature mutations in Gag without changes in HIV-1 replication Oscar Blanch-Lombarte Rome, 7-9 June, 2017 European
More informationBackground. A systematic analysis from previous studies reported the following prevalence:
High levels of resistance among HIV-1 treatment naive patients in Greece. a nationwide study: Evidence for country and regional level transmission networks D. Paraskevis 1. E. Kostaki 1. G. Magiorkinis
More informationSetting the Context: Understanding the Numbers, Vulnerable Populations and Federal Public Health Policy
Setting the Context: Understanding the Numbers, Vulnerable Populations and Federal Public Health Policy David B. Johnson STD Disparities Coordinator, Division of STD Prevention National Center for HIV/AIDS,
More informationIntroduction to HIV Drug Resistance. Kevin L. Ard, MD, MPH Massachusetts General Hospital Harvard Medical School
Introduction to HIV Drug Resistance Kevin L. Ard, MD, MPH Massachusetts General Hospital Harvard Medical School Objectives 1. Describe the epidemiology of HIV drug resistance in sub-saharan Africa. 2.
More informationAntiviral Therapy 2011; 16: (doi: /IMP1851)
Antiviral Therapy 2011; 16:925 929 (doi: 10.3851/IMP1851) Short communication Prevalence of low-level HIV-1 variants with reverse transcriptase mutation K65R and the effect of antiretroviral drug exposure
More informationCDC Support for Exit Screening & Lessons Learned for Preparedness
CDC Support for Exit Screening & Lessons Learned for Preparedness Nina Marano DVM MPH Dipl ACVPM Division of Global Migration and Quarantine Centers for Disease Control and Prevention National Center for
More informationAntiretroviral drug resistance surveillance among drug-naive HIV-1-infected individuals in Gauteng Province, South Africa in 2002 and 2004
Antiviral Therapy 13 Suppl 2:101 107 Antiretroviral drug resistance surveillance among drug-naive HIV-1-infected individuals in Gauteng Province, South Africa in 2002 and 2004 Visva Pillay 1, Johanna Ledwaba
More informationThyroid cancer in the United States: Recent increases
Thyroid cancer in the United States: Recent increases Meg Watson Epidemiology and Applied Research Branch Division of Cancer Prevention and Control CDC NAACCR Annual Conference June 22, 2011 National Center
More informationUpdate: ACIP Recommendations for Hepatitis B Vaccination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Update: ACIP Recommendations for Hepatitis B Vaccination Sarah Schillie, MD, MPH, MBA Summit for the Elimination of Hepatitis B and
More informationImproving PI drug resistance scores. Jens Verheyen, MD Institute of Virology University Duisburg-Essen
Improving PI drug resistance scores Jens Verheyen, MD Institute of Virology University Duisburg-Essen Overview Why can all PI drug resistance scores be improved? Do we still need to improve PI drug resistance
More informationWhole genome deep sequencing of HIV reveals extensive multi-class drug resistance in Nigerian patients failing first-line antiretroviral therapy
Whole genome deep sequencing of HIV reveals extensive multi-class drug resistance in Nigerian patients failing first-line antiretroviral therapy K El Bouzidi 1,, RP Datir 1, V Kwaghe 3, S Roy 1, D Frampton
More informationOptimizing 2 nd and 3 rd Line Antiretroviral Therapy in Children and Adolescents
Optimizing 2 nd and 3 rd Line Antiretroviral Therapy in Children and Adolescents Victor Musiime, MBChB, MMED, PhD Senior Lecturer, Makerere University Investigator, Joint Clinical Research Centre (JCRC)
More informationShould We Be Worried about HIV Resistance in Prevention Trials?
Should We Be Worried about HIV Resistance in Prevention Trials? John W Mellors, MD MTN Regional Meeting Cape Town, SA 25 Sept 2018 YES HIV Drug Resistance? HIV Drug Resistanc e NRTI + NNRTI Resistance
More informationSupplementary Methods. HIV Synthesis Transmission V1. Model details
Effect on transmission of HIV-1 resistance of timing of implementation of viral load monitoring to determine switches from first to second line antiretroviral regimens in resource-limited settings. Supplementary
More informationCharles Boucher MD. PhD. HIV Prevention 2.0
Charles Boucher MD. PhD HIV Prevention 2.0 Prevention A variety of methods exists to prevent transmission of HIV Circumcision Condoms Post-exposure profylaxe (PEP) Treatment as prevention Pre-exposure
More informationTrends in Testing for Mycobacterium tuberculosis Complex from US Public Health Laboratories,
Trends in Testing for Mycobacterium tuberculosis Complex from US Public Health Laboratories, 2009 2013 Frances Tyrrell, MT (ASCP), MPH Laboratory Consultant Laboratory Capacity Team (LCT)/DTBE ftyrrell@cdc.gov
More informationDrug-Selected Resistance Mutations and Non-B Subtypes in Antiretroviral-Naive Adults with Established Human Immunodeficiency Virus Infection
MAJOR ARTICLE Drug-Selected Resistance Mutations and Non-B Subtypes in Antiretroviral-Naive Adults with Established Human Immunodeficiency Virus Infection George J. Hanna, 1,a Henri U. Balaguera, 2,a Kenneth
More informationAntiretroviral treatment outcomes after the introduction of tenofovir in the public-sector in South Africa
Antiretroviral treatment outcomes after the introduction of tenofovir in the public-sector in South Africa Alana T Brennan, Kate Shearer, Mhairi Maskew, Prudence Ive, Ian Sanne, Matthew P Fox Health Economics
More informationNational Chlamydia Update
National Chlamydia Update Lizzi Torrone Chlamydia Epidemiologist Surveillance and Data Management Branch Region I, Wells Beach, Maine June 4-5, 2012 National Center for HIV/AIDS, Viral Hepatitis, STD,
More informationEvaluation and Management of Virologic Failure
National HIV Curriculum PDF created November 3, 2018, 12:26 am Evaluation and Management of Virologic Failure This is a PDF version of the following document: Section 1: Antiretroviral Therapy Topic 5:
More informationHIV Drug Resistance: An Overview
Human Journals Review Article October 2015 Vol.:1, Issue:1 All rights are reserved by Suraj Narayan Mali et al. HIV Drug Resistance: An Overview Keywords: HIV drug resistance mechanism, Antiretroviral
More informationNational Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Increased Hepatitis C Virus (HCV) Detection in Women of Childbearing Age and Potential Risk for Vertical Transmission - United States
More information2 nd Line Treatment and Resistance. Dr Rohit Talwani & Dr Dave Riedel 12 th June 2012
2 nd Line Treatment and Resistance Dr Rohit Talwani & Dr Dave Riedel 12 th June 2012 Overview Basics of Resistance Treatment failure Strategies to manage treatment failure Mutation Definition: A change
More informationDNA Genotyping in HIV Infection
Frontier AIDS Education and Training Center DNA Genotyping in HIV Infection Steven C. Johnson M.D. Director, University of Colorado HIV/AIDS Clinical Program; Professor of Medicine, Division of Infectious
More information(ii) The effective population size may be lower than expected due to variability between individuals in infectiousness.
Supplementary methods Details of timepoints Caió sequences were derived from: HIV-2 gag (n = 86) 16 sequences from 1996, 10 from 2003, 45 from 2006, 13 from 2007 and two from 2008. HIV-2 env (n = 70) 21
More informationHIV replication and selection of resistance: basic principles
HIV replication and selection of resistance: basic principles 26th International HIV Drug Resistance and Treatment Strategies Workshop Douglas Richman 6 November 2017 CLINICAL DATA DURING SIXTEEN WEEKS
More informationGenotypic Resistance Testing in Routine Care in South Africa:
Genotypic Resistance Testing in Routine Care in South Africa: Is the Juice Worth the Squeeze? Mark Siedner Africa Health Research Institute Harvard Medical School Conflicts of Interest^* No financial conflicts
More informationORIGINAL ARTICLE /j x. Brescia, Italy
ORIGINAL ARTICLE 10.1111/j.1469-0691.2004.00938.x Prevalence of drug resistance and newly recognised treatment-related substitutions in the HIV-1 reverse transcriptase and protease genes from HIV-positive
More informationEnhanced Comprehensive HIV Prevention Planning (ECHPP) Project Overview
Enhanced Comprehensive HIV Prevention Planning (ECHPP) Project Overview David W. Purcell, JD, PhD Deputy Director, Behavioral and Social Science Stephen Flores, PhD Team Lead, Prevention Research Branch
More informationSexual Health, HIV, and STDs
Sexual Health, HIV, and STDs Richard J. Wolitski, PhD Deputy Director, Behavioral and Social Science Division of HIV/AIDS Prevention Centers for Disease Control & Prevention Fenway Institute, Boston, MA
More informationTitle. HIV-1 Protease and Reverse Transcriptase Mutations: Correlations with Antiretroviral Therapy in
Title HIV-1 Protease and Reverse Transcriptase Mutations: Correlations with Antiretroviral Therapy in Subtype B Isolates and Implications for Drug-Resistance Surveillance October 13, 2004 Authors SY Rhee
More information6/10/2015. Background. Background. Background. Background. Methods
/1/1 The challenges of diversity: HIV-1 subtype distribution and transmission s within the Australian Molecular Epidemiology Network-HIV -1 Castley A, Sawleshwarkar S, Varma R, Herring B, Thapa K, Chibo
More informationViral Resistance with Topical RT-Microbicides. Ian McGowan MD PhD FRCP David Geffen School of Medicine Los Angeles
Viral Resistance with Topical RT-Microbicides Ian McGowan MD PhD FRCP David Geffen School of Medicine Los Angeles verview What antiretrovirals (ARV) are being considered as candidate microbicides? How
More informationARV Mode of Action. Mode of Action. Mode of Action NRTI. Immunopaedia.org.za
ARV Mode of Action Mode of Action Mode of Action - NRTI Mode of Action - NNRTI Mode of Action - Protease Inhibitors Mode of Action - Integrase inhibitor Mode of Action - Entry Inhibitors Mode of Action
More informationEstimating RSV Disease Burden in the United States
Estimating RSV Disease Burden in the United States Brian Rha, MD, MSPH Medical Epidemiologist, Division of Viral Diseases Centers for Disease Control and Prevention Severe Acute Respiratory Infection Surveillance
More informationHIV in the Brain MANAGING COMORBIDITIES IN PATIENTS WITH HIV
HIV in the Brain MANAGING COMORBIDITIES IN PATIENTS WITH HIV Shibani S. Mukerji MD, PhD Massachusetts General Hospital, Division of Immunologic, Inflammatory and Infectious Neurological Diseases Dana-Farber
More informationShow Me the Money: A Discussion about Investments Needed to Change STD Rates in the United States
Show Me the Money: A Discussion about Investments Needed to Change STD Rates in the United States Harrell Chesson Health Economist Centers for Disease Control and Prevention National Coalition of STD Directors
More informationLaboratory s Role in the Battle Against Drug Resistant Tuberculosis
Laboratory s Role in the Battle Against Drug Resistant Tuberculosis Angela M. Starks, Ph.D. Chief, Laboratory Branch Division of Tuberculosis Elimination June 6, 2016 National Center for HIV/AIDS, Viral
More informationAntiretroviral Prophylaxis and HIV Drug Resistance. John Mellors University of Pittsburgh
Antiretroviral Prophylaxis and HIV Drug Resistance John Mellors University of Pittsburgh MTN Annual 2008 Outline Two minutes on terminology Origins of HIV drug resistance Lessons learned from ART Do these
More informationAPACC 2016 HIV drug resistance. Shinichi Oka, MD, PhD. AIDS Clinical Center (ACC) National Center for Global Health and Medicine (NCGM)
APACC 2016 HIV drug resistance Shinichi Oka, MD, PhD. AIDS Clinical Center (ACC) National Center for Global Health and Medicine (NCGM) HIV drug resistance 1. Current situation of ART and TDR in Japan 2.
More informationSwitching strategies and ARV treatment costs
February 2014 Switching strategies and ARV treatment costs Josep M Llibre/Bonaventura Clotet Fundació Lluita contra la SIDA Hosp Univ Germans Trias i Pujol Badalona Rationale. Spain is under a huge economic
More informationTypes of HIV Resistance. How to count HIV primary resistance? List of protease mutations important for Surveillance
Mechanism of HIV drug resistance II. 1 - Head of Laboratório de Virologia Molecular UFRJ 2 -Associate Research Scientist, International Center for Aids Care and Treatment Programs-ICAP, Mailman School
More information14 TH EUROPEAN HIV & HEPATITIS MEETING Abst#_O_06
14 TH EUROPEAN HIV & HEPATITIS MEETING 2016 Abst#_O_06 Patients with pre-existent NRTI- and NNRTI-resistance have a higher risk to lose virological suppression under tenofovir/emtricitabine/rilpivirine
More informationTransmitted HIV Drug Resistance Is High and Longstanding in Metropolitan Washington, DC
Clinical Infectious Diseases MAJOR ARTICLE HIV/AIDS Transmitted HIV Drug Resistance Is High and Longstanding in Metropolitan Washington, DC Seble G. Kassaye, 1 Zehava Grossman, 2,3 Maya Balamane, 1 Betsy
More informationReview Article HIV-1 Genetic Variability and Clinical Implications
ISRN Microbiology Volume 2013, Article ID 481314, 20 pages http://dx.doi.org/10.1155/2013/481314 Review Article HIV-1 Genetic Variability and Clinical Implications Maria Mercedes Santoro 1 and Carlo Federico
More informationPerspective Resistance and Replication Capacity Assays: Clinical Utility and Interpretation
Perspective Resistance and Replication Capacity Assays: Clinical Utility and Interpretation Resistance testing has emerged as an important tool for antiretroviral management. Research continues to refine
More informationLooking to the Future in HIV Prevention:
Looking to the Future in HIV Prevention: A Health Department Perspective Angela C. Johnson, MPH, CHES Associate Director, Prevention ABOUT NASTAD WHO: A non-profit association founded in 1992 that represents
More informationSEXUAL TRANSMISSION. SEXUAL TRANSMISSION under ART: Biological Considerations
SEXUAL TRANSMISSION under ART: Biological Considerations Dr Steve Taylor, MB ChB, FRCP, PhD Consultant Physician, HIV/GU Medicine, Lead Consultant HIV Services, Directorate of Sexual Medicine and HIV Birmingham
More information