2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

Drug Resistance

• Acquired drug resistance

▫ Develops in a patient while on therapy

▫ Prescribing errors can lead to resistance

▫ Nonadherence can lead to resistance

• Primary drug resistance

▫ Acquired from a person with resistant virus

• Assessed by one of two technologies

▫ HIV genotyping

▫ HIV phenotyping

Slide31of 50FromSC Johnson, MD atNewOrleans, LA, December 4-7, 2019, Ryan WhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.

Transmitted HIV Drug Resistance - 23 U.S. Jurisdictions, 2016

20%

18%

16%

14%

12%

10%

8%

6%

4%

2%

0%

Any TDRM NNRTI

NRTI

PI

INSTI

McClunget al.CROI2019.Abst526.Seattle,Washington

Slide32of 50FromSC Johnson, MD atNewOrleans, LA, December 4-7, 2019, Ryan WhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.

HIV Resistance Tests

DNA Archive Resistance Tests

Standard RNA Resistance Tests

Slide33of 50FromSC Johnson, MD atNewOrleans, LA, December 4-7, 2019, Ryan WhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.