AREVIR, Köln, RESINA Dr. Björn Jensen

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1 AREVIR, Köln, RESINA Dr. Björn Jensen Klinik für Gastroenterologie, Hepatologie und Infektiologie Universitätsklinikum Düsseldorf

2 The RESINA Study (Genotypic HIV-Resistance in Treatment-Naives) Ongoing prospective study in Nordrhein-Westfalen Inclusion: Untreated HIV-infected subjects before ART initiation Study period: Aims of study: Epidemiology of primary resistance in chronically HIV-infected patients Evaluation of efficacy of HAART guided by resistance testing Bioinformatic analysis of resistance data Subgroup analyses Classification of resistance: Shafer RW et al., Antiviral Therapy 2009 Until end of 2014: 3811 patients (with sequence) in 36 centers Funding: Federal Ministry of Health and Social Security (BMG) Heinz-Ansmann-Foundation for AIDS-Research

3 RESINA Nationality w/o SSA (n=3319) Brazil 0,7% Poland 1,1% Italy 0,9% Russian Federation 1,4% Thailand 1,7% Turkey 2,4% Greece 0,5% Spain 0,5% Portugal France 0,4% Netherlands 0,4% 0,3% Ukraine 0,3% not documented 3,5% Others (each N < 10) 5,1% not documented Germany Turkey Thailand Russian Federation Poland Italy Brazil Greece Spain France Portugal Netherlands Ukraine Others (each N < 10) Germany 80,8%

4 RESINA Nationality only SSA(n=372) other countries 19,1% Cameroon 16,1% Sierra Leone 2,7% Ethiopia 3,2% Cote d'ivoire 3,8% Kenya 15,9% Cameroon Kenya Togo Nigeria Ghana Congo, Republic of (Brazzaville) Cote d'ivoire Congo, Republic of (Brazzaville) 6,7% Ghana 10,2% Nigeria 10,8% Togo 11,6% Ethiopia Sierra Leone other countries

5 RESINA Subtypes (n=2797) subtypes male patients C 1,5% 02_AG 4,4% 01_AE 3,5% A1 4,6% G other 0,9% 2,1% B C 02_AG 01_AE A1 G other B 83,1%

6 RESINA Subtypes (n=630) subtypes female patients 12,7% 4,9% 30,3% 16,0% 7,6% 9,5% B C 02_AG 01_AE A1 G other 18,9%

7 Trends of primary HIV drug resistance: RESINA (n=3452) 16,0% 14,0% 12,0% 10,0% 8,0% 6,0% any NRTI NNRTI PI REVERT 4,0% 2,0% 0,0%

8 Tropism: RESINA (n=325) 100,0% 90,0% 80,0% 70,0% 60,0% 50,0% 40,0% X4 X4R5 R5 30,0% 20,0% 10,0% 0,0%

9 Trends of HIV drug resistance: AREVIR (w/o RESINA, after ART) %

10 RESINA Summary The RESINA study provides a diverse and representative study cohort TDR has to be expected in around 10% of chronically HIV-1 infected Patients TDR is not decreasing in this cohort despite decreasing resistance in therapy-experienced patients; TDR even tends to increase overall and in the NNRTI-group

11 RESINA-Study Centers Praxis Arbter, Krefeld Praxis Baumann, Neuss Praxis Becker-Boost, Duisburg Praxis Busch, Christenen, Münster Praxis Carls, Huber, Düsseldorf Praxis Dresch, Köln Uniklinik Essen, S. Esser Uniklinik Köln, G. Fätkenheuer Praxis Ferdinand, Köln Praxis Gantke, Düsseldorf Praxis Gippert, Hartmann, Quaing, Münster Praxis Grüneberg, Münster Praxis Radecki, Köln Klinikum Dortmund, M. Hower, Dortmund Praxis Isernhagen, Römer, Qurishi, Köln Praxis Knechten, Habets, Aachen Praxis Köthemann, Neuwirth, Köln Praxis Kwirant, Duisburg Praxis Mauruschat, Wuppertal Praxis Mauss, Schmutz, Hegener, Düsseldorf Praxis Miasnikov, Düsseldorf Krankenhaus der Augustinerinnen, M. Oette, Köln Klinikum Osnabrück, A. Mutz Uniklinik Düsseldorf, B. Jensen, T. Feldt, D. Häussinger Praxis Reith, Düsseldorf Klinik Kemperhof, A. Rieke, Koblenz Uniklinik Bonn, J. Rockstroh Praxis Schäfer, Bielefeld Praxis Schoelzel, Troisdorf Praxis Scholten, Köln Krankenhaus Hagen, T. Scholten, Hagen Praxis Schons, Düsseldorf Praxis Schuster, Wuppertal Praxis Stechel, Juretzko, Köln Praxis Strehlow, Petry, Düsseldorf Praxis Wiesel, Theisen, Voigt, Köln

12 Dieter Häussinger, Mark Oette, Stefan Reuter, Ulrike Haars, Falk Hüttig, Abdurrahman Sagir, Carola Blondin Department for Gastroenterology, Hepatology and Infectious Diseases University Hospital of Düsseldorf, Germany Rolf Kaiser, Claudia Müller, Herbert Pfister, Eugen Schülter, Melanie Balduin, Nadine Lübke, Finja Schweitzer, Jens Verheyen, Veronica di Cristanziano, Elena Knops, Angelika Hergesell Institute for Virology, University of Köln, Germany Thomas Lengauer and team, Niko Beerenwinkel Max Planck Institute for Bioinformatics, Saarbrücken