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By Y. Arakos. Grove City College. 2019.

Escape of human immunodeficiency virus from immune control purchase tadapox american express. Parasite dose determines the Th1/Th2 nature of the response to Leishmania major independently of infection route and strain of host or parasite generic tadapox 80mg with amex. Pattern of nucleotidesubstitution and rate heterogeneity in the hypervariable regions I and II of human mtDNA discount 80mg tadapox. Molecular basis of surface antigen variation in Neisseria tadapox 80 mg with amex. Cooperation and conflict in the evolution of individuality. Extensive diversity in the recogni- tion of influenza virus hemagglutinin by murine T helper clones. Partitioning of genetic variation between regulatory and coding gene segments: the predominance of software variation in genes en- coding introvert proteins. Natural variation in immune responsiveness, with special reference to immunodeficiency and promoter polymorphism in class II MHC genes. Computer-assisted analysis of envelope protein sequences of seven human immunodeficiency isolates: predictions of antigenic epitopes in con- served and variable regions. Germline TCR- Arestriction of immunoglobulin E responses to allergen. Integrin ανβ3res- cues melanoma cells from apoptosis in three-dimensional dermal collagen. Proceedings of the National Academy of Sciences USA 91:8856–8860. New polymor- phism of the human T-cell receptor AV28S1 gene segment. Identification of the nonamer peptide from influenza A matrix protein and the role of pockets of HLA-A2 in its recognition by cytotoxic T lymphocytes. Immunobiology of cytotoxic T-cell escape mutants of lymphocytic choriomeningitis virus. Neutralization of picor- naviruses: support for the pentamer bridging hypothesis. Adaptive evolu- tion of highly mutable loci in pathogenic bacteria. The evolu- tion of RNA viruses: a population genetics view. Proceedings of the National Academy of Sciences USA 97:6967–6973. Stable expression of mosaic coats of variant surface glycoproteins in Trypanosoma brucei. Molecular comparison of group A streptococci of T1M1 serotype from invasive and noninvasive infections in Finland. Counting antigen-specific CD8 T cells: a reevaluation of bystander activation during viral infection. Hierar- chy among multiple H-2b-restricted cytotoxic T-lymphocyte epitopes within simian virus 40Tantigen. The role of lysosomal proteinases in MHC class II–mediated antigen processing and presentation. Variation in response among individuals to antigenic sites on the HA protein of human influenza virus may be responsible for the emergence of drift strains in the human population. Epitope selection in a primary response is thermodynamically regulated. Deceptive imprinting: a cosmopolitan strategy for complicating vaccination. Frequency of naturally occurring antibody to influenza virus antigenic variants selected in vitro with mono- clonal antibody. Natural and ‘in vitro’ selected antigenic variants of influenza A virus (H2N2). Kinetic regulation of repertoire discrimination and antibody optimization for epitope. Inferring population history from molecular phylogenies. Philosophical Transactions of the Royal Society of London B 349:25–31. Foot-and-mouth disease virus virulent for cattle utilizes the integrin αvβ3 as its receptor. Looking back for a view of the future: observations of immu- nity to induce malaria. American Journal of Tropical Medicine and Hygiene 26:211–215. Patterns of antibody specificity during the BALB/c immune response to hen egg whitelysozyme. Contribution of proteasome- mediated proteolysis to the hierarchy ofepitopes presented by major histo- compatibility complex class I molecules. The specificity of proteasomes: impact on MHC class I processing and presentation of antigens. The proteolytic fragments generated by verte- brate proteasomes: structural relationships to major histocompatibility com- plex class I binding peptides. Proceedings of the National Academy of Sciences USA 93:8572–8577. Adaptation of wild-type measles virus to CD46 receptor usage. Naturally occurring variants of human T-cell leuke- mia virus type I Tax protein impair its recognition by cytotoxic T lymphocytes and the transactivation function of Tax. Virus Dynamics: Mathematical Principles of Immunology andVirology. Antigenic oscillations and shifting immunodominance in HIV-1 infections. A single amino acid substitution in nonstructural protein 3A can mediate adaptation of foot-and-mouth disease virus to the guinea pig. Study of the dynamics of neutralization escape mutants in a chim- panzee naturally infected with the simian immunodeficiency virus SIVcpz- ant. Conserved and exposed epitopes on intact, native, primary human immunodeficiency virus type 1 virions of group M. Immunoreactivity of intact virions of human immu- nodeficiency virus type 1 (HIV-1) reveals the existence of fewer HIV-1 im- munotypes than genotypes. Multivariate analysis of human immunodeficiency virus type 1 neutralization data. Lateral gene transfer and the nature of bacterial innovation. Control of early viral and bacterial distribution and disease by natural antibodies. Protective long-term antibody memory by antigen- driven and T help-dependent differentiation of long-lived memory B cells to short-lived plasma cells independent of secondary lymphoid organs. Pro- ceedings of the National Academy of Sciences 97:13263–13268. The im- plications of intergenic polymorphism for major histocompatibility complex evolution. Probing the genetic population structure of Trypanosoma cruzi with polymorphic microsatellites. Proceedings of the National Academy of Sciences USA 95:3776–3780. The population structure of Trypanosoma cruzi: expanded analysis of 54 strains using eight polymorphic CA-repeat microsatellites. Senescence in organisms with clonal reproduction and com- plex life histories. A sin- REFERENCES 297 gle residue exchange within a viral CTL epitope alters proteasome-mediated degradation resulting in lack of antigen presentation. Detectingthe form of selection from DNA sequence data. Selection forces and constraints on retroviral sequence variation. Influenza A pandemics of the 20th century with special reference to 1918: virology, pathology and epidemiology.

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Surrogate outcome: Outcome measures that are not of direct practical importance but are believed to reflect outcomes that are important; for example order 80 mg tadapox otc, blood pressure is not directly important to patients but it is often used as an outcome in clinical trials because it is a risk factor for stroke and heart attacks tadapox 80mg on-line. Surrogate endpoints are often physiological or biochemical markers that can be relatively quickly and easily measured cheap tadapox 80 mg line, and that are taken as being predictive of important clinical outcomes cheap 80 mg tadapox mastercard. They are often used when observation of clinical outcomes requires long follow-up. Nonsteroidal antiinflammatory drugs (NSAIDs) 62 of 72 Final Report Update 4 Drug Effectiveness Review Project Survival analysis: Analysis of data that correspond to the time from a well-defined time origin until the occurrence of some particular event or end-point; same as time-to-event analysis. Systematic review: A review of a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant research and to collect and analyze data from the studies that are included in the review. The extent to which a drug’s adverse effects impact the patient’s ability or willingness to continue taking the drug as prescribed. These adverse effects are often referred to as nuisance side effects, because they are generally considered to not have long-term effects but can seriously impact compliance and adherence to a medication regimen. Treatment regimen: The magnitude of effect of a treatment versus no treatment or placebo; similar to “effect size”. Can be calculated in terms of relative risk (or risk ratio), odds ratio, or risk difference. Two-tailed test (two-sided test): A hypothesis test in which the values that reject the null hypothesis are located in both tails of the probability distribution. For example, testing whether one treatment is different than another (rather than testing whether one treatment is either better than another). Type I error: A conclusion that there is evidence that a treatment works, when it actually does not work (false-positive). Type II error: A conclusion that there is no evidence that a treatment works, when it actually does work (false-negative). Validity: The degree to which a result (of a measurement or study) is likely to be true and free of bias (systematic errors). Variable: A measurable attribute that varies over time or between individuals. Variables can be • Discrete: taking values from a finite set of possible values (e. Washout period: [In a cross-over trial] The stage after the first treatment is withdrawn, but before the second treatment is started. The washout period aims to allow time for any active effects of the first treatment to wear off before the new one gets started. Nonsteroidal antiinflammatory drugs (NSAIDs) 63 of 72 Final Report Update 4 Drug Effectiveness Review Project Appendix D. Search strategies for Update 4 Searches were repeated in June 2010 to identify additional citations. Database: Ovid MEDLINE(R) <1996 to April Week 1 2010> Search Strategy: -------------------------------------------------------------------------------- 1 celecoxib. Excluded studies for Update 4 The following full-text publications were considered for inclusion but failed to meet the criteria for this report. See previous versions of the report on the Drug Effectiveness Review Project website for studies excluded previously. Exclusion codes 2=ineligible outcome, 3=ineligible intervention, 4= ineligible population, 5= ineligible publication type, 6= ineligible study design Exclusion Excluded studies code Head-to-head trials de Boer TN, Huisman AM, Polak AA, et al. The chondroprotective effect of selective COX-2 inhibition in osteoarthritis: ex vivo evaluation of human cartilage tissue after in vivo 2 treatment. Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society. Small bowel mucosal injury is reduced in health subjects treated with celecoxib compared with ibuprofen plus omeprazole, as assessed by 6 video capsule endoscopy. Goldstein J, Eisen G, Lewis B, Gralnek I, Zlotnick S, Fort J. Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and 6 placebo. Goldstein J, Hochberg M, Fort J, Zhang Y, Hwang C, Sostek M. Clinical Trial: the incidence of NSAID-associated endoscopic gastric ulcers in patients treated with PN 400 (naproxen 3 plus esomeprazole magnesium) vs. Diclofenac plus B vitamins versus diclofenac monotherapy in lumbago: the DOLOR study. Celecoxib, ibuprofen, and the antiplatelet effect of aspirin in patients with osteoarthritis and ischemic heart disease. Efficacy and safety of piroxicam patch versus piroxicam cream in patients with lumbar osteoarthritis. Treatment of patients with osteoarthritis with rofecoxib compared with nabumetone. Active-control trials Chang ST, Chen LC, Chang CC, Chu HY, Hsieh MF, Tsai KC. Efficacy and safety of piroxicam beta-cyclodextrin sachets for treating chronic low back pain: a randomized, 4 parallel, active-controlled trial. Comfrey extract ointment in comparison to diclofenac gel in the treatment of acute unilateral ankle sprains (distortions). Das Gupta AB, Hossain AKMM, Islam MH, Dey SR, Khan AL. Role of omega-3 fatty acid supplementation with indomethacin in suppression of disease activity in rheumatoid arthritis. Aug 2009;35(2):63-68 Esparza F, Cobian C, Jimenez JF, et al. Topical ketoprofen TDS patch versus diclofenac 4 gel: efficacy and tolerability in benign sport related soft-tissue injuries. British Journal of Nonsteroidal antiinflammatory drugs (NSAIDs) 69 of 72 Final Report Update 4 Drug Effectiveness Review Project Exclusion Excluded studies code Sports Medicine. Fleischmann R, Sheldon E, Maldonado-Cocco J, Dutta D, Yu S, Sloan VS. Lumiracoxib is effective in the treatment of osteoarthritis of the knee: a prospective randomized 13-week 6 study versus placebo and celecoxib. Assessment of diclofenac or spinal manipulative therapy, or both, in addition to recommended first-line treatment for acute low back pain: a 6 randomised controlled trial. Effect of risk factors on complicated and uncomplicated ulcers in the TARGET lumiracoxib outcomes study. Does gastrointestinal adverse drug reaction influence therapeutic effect in the treatment of rheumatoid arthritis? Laine L, Curtis SP, Cryer B, Kaur A, Cannon CP, Committee MS. Assessment of upper gastrointestinal safety of etoricoxib and diclofenac in patients with osteoarthritis and 6 rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: a randomised comparison. Levy RM, Saikovsky R, Shmidt E, Khokhlov A, Burnett BP. Flavocoxid is as effective as naproxen for managing the signs and symptoms of osteoarthritis of the knee in humans: a 6 short-term randomized, double-blind pilot study. The effectiveness of a weak opioid medication versus a cyclo-oxygenase-2 (COX-2) selective non-steroidal anti-inflammatory drug in treating flare-up of chronic low-back pain: results 6 from two randomized, double-blind, 6-week studies. Efficacy and safety of aceclofenac in the treatment of osteoarthritis: a randomized double-blind comparative clinical trial versus 6 diclofenac -an Indian experience. Glucosamine but not ibuprofen alters cartilage turnover in osteoarthritis patients in response to physical training. Pregabalin, celecoxib, and their combination for treatment of chronic low-back pain. Rother M, Lavins BJ, Kneer W, Lehnhardt K, Seidel EJ, Mazgareanu S. Efficacy and safety of epicutaneous ketoprofen in Transfersome (IDEA-033) versus oral celecoxib and placebo 6 in osteoarthritis of the knee: multicentre randomised controlled trial. Smugar SS, Schnitzer TJ, Weaver AL, Rubin BR, Polis AB, Tershakovec AM. Comparison of intra-articular tenoxicam and oral tenoxicam for pain and physical functioning in osteoarthritis of the knee. Efficacy of lumiracoxib in relieving pain associated with knee osteoarthritis: A 6-week, randomized, double-blind, parallel-group 6 study. Nonsteroidal antiinflammatory drugs (NSAIDs) 70 of 72 Final Report Update 4 Drug Effectiveness Review Project Exclusion Excluded studies code Bingham CO, 3rd, Sebba AI, Rubin BR, et al.

Indications and trade name: prophylaxis and treatment of cerebral toxoplasmosis discount tadapox 80mg otc. For PCP prophylaxis in combination with dapsone tadapox 80 mg otc, Daraprim 2 tablets (50 mg) per week + Dapsone 1 tablet (50 mg) QD + Leucovorin 2 tablets (30 mg) per week order tadapox. Side effects: nausea generic tadapox 80mg on line, colic, vomiting, diarrhea, leukopenia, anemia or thrombocy- topenia. Interactions, warnings: pyrimethamine is contraindicated in megaloblastic anemia resulting from folic acid deficiency. Caution in patients with seizures, renal failure, asthma or G6PD deficiency. All patients taking pyrimethamine should receive folinic acid (not folic acid) to decrease risk of myelosuppression. Initial monitoring of blood count at weekly intervals. Indications and trade names: treatment-naïve and pretreated HIV+ patients. In patients with renal or moderate hepatic impairment, no dose adjustment is required. The lower dosage in Dutrebis is possible due to a new formulation. Side effects: raltegravir is very well tolerated – in studies, there have generally been no more adverse events than seen with placebo. At a frequency of 1% to 10%, dizzi- ness, stomach ache, flatulence, obstipation, hyperhidrosis, arthralgia, tiredness, weakness. Case reports on rhabdomyolysis, hepatitis, insomnia. Interactions, warnings: raltegravir is eliminated via UGT1A1-mediated glu- curonidation, so that relevant interactions with other antiretroviral agents are unlikely. Strong inducers of UGT1A1 like rifampicin reduce plasma levels of ralte- gravir. If a combination is unavoidable, raltegravir dose should be doubled. Omeprazole or other gastric acid inhibitors may increase the plasma levels of ralte- gravir. Comments: first-in-class integrase strand transfer inhibitor. Well-tolerated, effective in the setting of multiple resistances as well as in ART-naïve patients. Relatively low resistance barrier, BID dosing required (new once daily formulation currently under investigation). For detailed information see page: 102 Rebetol, see Ribavirin. Indications and trade names: chronic hepatitis C, only in combination with inter- feron and with some DAAs. In Europe, the license for HIV/HCV-coinfected patients only applies to Copegus. Solution, 40 mg/ml Dosage: daily dose 800 mg for body weight <65 kg, 1000 mg for 65–85 kg, 1200 mg for >85 kg. Capsules are divided into two daily doses and taken with meals. Treatment duration depends on the genotype and success of treatment. Drug Profiles 707 Side effects: the most frequent side effect is hemolytic anemia (Hb decrease by at least 2 g/dl obligatory), gastrointestinal complaints, headache and fatigue may also occur. Rarely lactic acidosis, pancreatitis in combination with NRTIs. Interactions, warnings: ribavirin is contraindicated in severe coronary disease, renal failure, decompensated liver cirrhosis, and hemoglobinopathy. It is also contraindi- cated in pregnancy (teratogenicity). Before reducing or discontin- uing ribavirin, however, consider erythropoietin and transfusions. Avoid concurrent treatment with other myelosuppressive drugs (AZT). Ribavirin can lead to lactic acidosis in combination with other NRTIs. Most impor- tantly, ddI should be avoided while care should be taken with all other NRTIs like d4T. Possible antagonism with abacavir (mechanism unclear). Efavirenz-induced depression may worsen on ribavirin. Monitoring of lab values (blood count, ALT, amylase, lipase) initially at biweekly intervals and then monthly. Comments: still used with some DAA combinations for HCV therapy. Indications and trade name: infections with Mycobacterium avium complex (MAC) in combination with other drugs (usually ethambutol and azithromycin). Also for patients with tuberculosis, when rifampicin is contraindicated. Dosage: 300 mg rifabutin daily (+ azithromycin + ethambutol). Renal failure, dose reduction by 50% for creatinine clearance <30 ml/min. Dose adjustments for concurrent dosing with antiretroviral drugs: Drug Recommendation Atazanavir/r, darunavir/r, fosamprenavir/r, Rifabutin: 150 mg every other day or three times indinavir/r, lopinavir/r, saqui-navir/r, tipranavir/r per week (see product information) Nelfinavir Nelfinavir 1250 mg BID + rifabutin 150 mg/day Efavirenz Increase rifabutin to 450 mg/day or 600 mg twice or three times weekly Nevirapine Standard dose Side effects: Nausea, vomiting, elevation of liver enzymes, jaundice. Uveitis usually only with a daily dose >300 mg and concurrent treatment with clarithromycin or fluconazole. Red discoloration of urine, skin and body secretions (inform patients about this). Interactions, warnings: Rifabutin should not be used in thrombocytopenia and severe hepatic dysfunction. Monitor blood count and liver enzymes initially biweekly and then monthly. Rifabutin can decrease the efficacy of the following drugs: analgesics, anticoagulants, corticosteroids, cyclosporine, digitalis (except digoxin), dapsone, oral antidiabetics, oral contraceptives, narcotic analgesics, phenytoin and quinidine. Erythromycin, different azoles can increase plasma levels of rifabutin. Antacids should be taken at least three hours after rifabutin. Side effects: toxic hepatitis (up to 20%), cholestatic changes. Red discoloration of urine and other body fluids (inform patients of this). Interactions, warnings: caution in patients with chronic liver disease. Discontinue rifampin if ALT >100 U/l or with elevated bilirubin (careful on re-exposure, gradu- ally increasing doses is possible after normalization of values), and with patients who experience severe and persistent diarrhea (pseudomembranous colitis). Rifampin should be avoided if concurrent NNRTIs or PIs are necessary. Rifampin increases metabolism of numerous drugs, reducing their efficacy if administered concurrently. These drugs include atovaquone, warfarin, barbiturates, benzodi- azepines, beta blockers, clarithromycin, contraceptives, steroids, oral antidiabetics, cyclosporine, dapsone, digitalis, doxycycline, erythromycin, haloperidol, ketocona- zole, methadone, phenytoin, theophylline, trimethoprim, verapamil. Combination with ketoconazole or voriconazole is contraindicated.

It remains unclear if R5-tropic virus with resistance to maraviroc may be suppressed by using monoclonal antibodies such as PRO 140 proven 80 mg tadapox. In contrast to maraviroc or vicriviroc order generic tadapox pills, PRO 140 binds extracellularly to the CCR5 coreceptor effective 80mg tadapox. Therefore cheap tadapox generic, cross- resistance between PRO 140 and maraviroc is unlikely (Jacobson 2009). Summary Resistance and tropism tests are standard diagnostic tools in the management of HIV infection and are recommended by treatment guidelines. Primary resistant viral vari- ants can be observed in about 10% of treatment-naïve patients in regions that have access to antiretroviral drugs. Resistance testing prior to initiating ART results in significantly better response rates. The emergence of viral mutants is one of the main causes of virological treatment failure. Pharmacoeconomic studies have shown that genotypic resistance tests concerning reverse transcriptase and protease are cost-effec- tive both in treatment-experienced and in ART-naïve patients (Weinstein 2001, Corzillius 2004, Sax 2005). Sequencing of the genomic regions of integrase and gp41 should be included in the evaluation of resistance – at least at time of treatment failure and when a treatment change is needed. Genotypic and phenotypic resistance/tropism tests show good intra- and inter-assay reliability. The interpretation of genotypic resistance profiles has become very complex and requires constant updating of respective guidelines. The determination HIV Resistance and Viral Tropism Testing 319 of the thresholds associated with clinically relevant phenotypic drug resistance is crucial for the effective use of (virtual) phenotypic testing. As for of resistance testing, genotyping has become the preferred method of tropism testing in clinical practice. With the co-receptor tool of geno2pheno, viral tropism can be predicted. Even though treatment failure requires the consideration of all causal factors such as patient adherence, metabolism of drugs and drug levels, resistance testing and measurement of viral tropism are of great importance in antiretroviral therapy. Finally, it needs to be emphasized that even with the benefit of well-interpreted resistance and tropism tests only experienced HIV practitioners should start, stop or change antiretroviral therapy keeping in mind the clinical and the psychosocial situation of the patient. Resistance tables All tables are based on rules-based interpretation systems such as HIV-GRADE (www. These tables should not replace interpretation tools and com- munication between the practitioner and the laboratory experts. Table 8: Mutations on the reverse transcriptase gene leading to NRTI resistance RTI Resistance mutations Zidovudine T215 Y/F (esp. They lead to high PI cross-resistance Table 11: Mutations leading to entry inhibitor resistance Entry inhibitor Resistance mutations T-20 G36A/D/E/S/V or I37V or 38A/M/E/K/V or Q39R Q40H/K/P/R/T or N42T/D/S or N42T+(N43S/N43K) N43D/KH/S or L44M or L44M+ G36S or L45M/L/Q Maraviroc Individual RAMs described; no consistent pattern The reduction in susceptibility is generally higher for double than for single mutations 322 ART Table 12: Mutations on the integrase gene leading to INSTI resistance Integrase inhibitors Resistance mutations Other mutation and resistance (Resistance pathways and profiles conferring or increasing key mutations) resistance Raltegravir Q148H/G/K/R/E L74M, E92Q/V, T66I, T97A N155H G118R, E138A/K, G140A/S Y143R/C Y143H, V151I/A/L, E157Q T66I + E92Q G163R/K, S230R The appearance of additional mutations produces an increase in the level of resistance Elvitegravir T66I/A/K H51Y, T66Q, L68V, V72I, E92V/G, E92Q Q95K, G118R, E138K, T97A G140AS, Y143R, E157Q, S230R S147G Q148R N155H Dolutegravir Q148R + G140S H51Y, L74IM, E92Q, E138A/K/T, G148H/K/R plus 2 additional G140S/A mutations out of G140A/C/S, L74I, N155H+E92Q E138A/K/T G118R R263K References Abram M, Hluhanich R, Goodman D, et al. Effect on primary Elvitegravir mutations in HIV-integrase on drug susceptibility and viral replication fitness. Abstract 3, XXI Int Workshop on HIV and hepatitis virus drug resist- ance and curative strategies 2012, Sitges, Spain. TMC125, a novel next-generation NNRTI active against nonnucleoside reverse transcriptase inhibitor-resistant HIV type 1. TMC278, a next-generation nonnucleoside reverse transcriptase inhibitor (NNRTI), active against wild-type and NNRTI-resistant HIV-1. Estimation of phenotypic clinical cut-offs for vircoType HIV-1 through meta analyses of clinical trial and cohort data. A randomized study of antiretroviral management based on plasma genotypic antiretroviral resistance testing in patients failing therapy. Genotypic changes in human immunodeficiency virus type 1 protease associated with reduced susceptibility and virologic response to the protease inhibitor tipranavir. Geno2pheno: estimating phenotypic drug resistance from HIV-1 geno- types. Drug resistance mutations for surveillance of transmitted HIV – 1 drug resistance : 2009 update. A comparison of the phenotypic susceptibility profiles of emtricitabine and lamivudine. Predictive value of peripheral blood mononuclear cells HIV-1 genotype in detect- ing treatment resistance among patients with low or undetectable viral load. Global antiviral journal 2015; 11 Suppl 1:8 (Abstract 4) Braun P, Wiesmann F. Phenotypic assays for the determination of coreceptor tropism in HIV-1 infected individ- uals. Genotypic and phenotypic HIV Tropism testing predicts the outcome of Maraviroc regimens. Abstract 47, XVIII IHDRW 2009, Fort Myers/Antiviral Therapy Vol. Brillant J, Klumpp K, Swallow S, Cammack N, Heilek-Snyder G. In vitro resistance development for a second-gen- eration NNRTI: TMC125. Molecular and clinical epidemiology of CXCR4-using HIV-1 in a large population of antiretroviral-naive individuals. Increased detection of the HIV-1 reverse transcriptase M184V muta- tion using mutation-specific minority assays in a UK surveillance study suggests evidence of unrecognized trans- mitted drug resistance. HIV Resistance and Viral Tropism Testing 323 Buonaguro L, Tornesello ML and F. Human Immunodeficiency Virus Type 1 Subtype Distribution in the Worldwide Epidemic: Pathogenetic and Therapeutic Implications. Dolutegravir versus raltegravir in antiretroviral-experienced, integrase- inhibitor-naive adults with HIV: week 48 results from the randomised, double-blind, noninferiority SAILING study. Cross-resistance profile of the novel integrase inhibitor Dolutegravir (S/GSK1349572) using clonal viral variants selected in patients failing raltegravir. Time trends in primary resistance to HIV drugs in the UK: multicentre obser- vational study. Lamivudine monotherapy in HIV-1-infected patients harbouring a lamivu- dine-resistant virus: a randomized pilot study (E-184V study). Stable frequency of HIV-1 transmitted drug resistance over a decade (1996– 2006) in France is likely explained by the increase of chronically treated patients in virological success? Dolutegravir in antiretroviral-experienced patients with raltegravir- and/or elvitegravir-resistant HIV-1: 24-week results of the phase III VIKING-3 study. Fosamprenavir: a review of its use in the management of antiretroviral therapy-naive patients with HIV infection. Once-daily dolutegravir versus darunavir/ritonavir in antiretroviral naive subjects: 48 week sub- group analyses from FLAMINGO. Abstract LBPS4/6, 14th EACS, 2013, Brussels, Belgium. A randomized trial assessing the impact of phenotypic resistance testing on antiretroviral therapy. Identification of I50L as the signature atazanavir-resistance mutation in treatment-naive HIV-1-infected patients receiving ATV-containing regimens. Pathways to Atazanavir resistance in treatment-experienced patients on Atazanavir containing regimens. Failure of lopinavir-ritonavir containing regimen in an antiretroviral-naive patient. Baseline phenotypic susceptibility to tipranavir/ritonavir is retained in iso- lates from patients with multiple protease inhibitor experience (BI 1182. Cost effectiveness analysis of routine use of genotypic anti- retroviral resistance testing after failure of antiretroviral treatment for HIV. Deutsch-Österreichische Leitlinien zur antiretroviralen Therapie der HIV-1- Infektion, Stand Mai 2014. HIV-1 resistance patterns to integrase inhibitors in antiretroviral- experienced patients with virological failure on raltegravir-containing regimens. Retention of HIV-1 drug resistance mutations in proviral DNA during second-line suppression. Global antiviral journal 2015; 11 Suppl 1:15 (Abstract 12) Delaugerre C, Flandre P, Chaix ML, et al. Protease gene mutations in a trial comparing first-line lopinavir/riton- avir monotherapy to lopinavir/ritonavir + zidovudine/lamivudine (MONARK-TRIAL). Protease inhibitor resistance analysis in the MONARK trial comparing first-line lopinavir-ritonavir monotherapy to lopinavir-ritonavir plus zidovudine and lamivudine triple therapy.

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