420. HIV Resistance Testing in Treatment-naive Patients at the Time of Entry into Care at a Community-based Infectious Disease Clinic
Session: Poster Abstract Session: HIV - Antiretroviral Therapy
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • HIV Resistance Testing com-96x48-Pro (4).pdf (336.2 kB)
  • Background: Studies of treatment-naïve HIV-infected individuals suggest that the risk of acquiring virus resistant to >1 antiretroviral (ARV) drug is 6-16%, and the risk of acquiring virus resistant to >1 class is 3-5%. In 2007 and 2008, respectively, the Department of Health and Human Services and the International AIDS Society-USA recommended that baseline resistance testing be performed in all treatment-naïve HIV-infected persons at the time of entry into care, regardless of duration of infection.  The Waterbury Hospital Infectious Disease Clinic (WHIC) is a Ryan White-funded site; its providers strive to adhere to contemporary guidelines while caring for ~500 adults living with HIV/AIDS.

    Methods:  As part of a quality control project, the clinic’s electronic medical record was queried; a retrospective analysis was performed of all treatment-naïve HIV-infected patients who entered into care between 2007and 2010. Baseline genotyping results were used to assess providers’ compliance with national guidelines. In addition, data was used to calculate the rate of transmitted drug resistance; contingency tables were used to evaluate for clinical features associated with the transmission of drug resistant virus. 

    Results: Between 2007and 2010, 314 HIV-infected patients entered into care at the WHIC, of which 125 were ARV treatment-naïve. WHIC providers ordered genotyping on 114 (91.2%) of these patients; testing was actually performed on 102 patients. Overall, 9% of patients tested had > 1 resistance mutation; no patient had resistance mutations to >1 class of ARV drug. By class, 3% had mutations conferring resistance to nucleoside reverse transcriptase inhibitors, 5% to non-nucleoside reverse transcriptase inhibitors, and 1% to protease inhibitors. The characteristics of patients with mutations did not differ statistically from those of patients without mutations, including ethnicity, reported HIV risk factor, and duration and stage of HIV infection.

    Conclusion: WHIC providers have successfully adopted national guidelines for the performance of HIV resistance testing. Baseline genotyping in treatment-naïve persons at the time of entry into care provides valuable information that may impact the eventual choice of ARV drug therapy. 


    Subject Category: H. HIV/AIDS and other retroviruses

    Svetlana Gerasimova, MD, Infectious Diseases, Kazan State Medical University, Kazan, Russia and Steven Aronin, MD, Infectious Diseases, Waterbury Hospital, Waterbury, CT

    Disclosures:

    S. Gerasimova, None

    S. Aronin, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.