CCO Management Series
Antiretroviral Resistance and Options for Sequencing
Mechanisms of HIV-1 Drug Resistance
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Module 1 of 5
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CME Program Director:
John P. Phair, MD
Program Director:
Andrew R. Zolopa, MD
 
- Mark A. Winters, MS
- Robert M. Grant, MD, MPH, MS
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 Mark A. Winters, MS, and Robert M. Grant, MD, MPH, MS, provide insight into current knowledge of mechanisms related to the generation of HIV-1 resistance to antiretroviral drugs. Learning Objectives
Upon completion of this activity, participants should be able to:
- Describe the molecular basis for drug resistance
- List factors that influence the evolution of drug-resistant HIV-1 variants
- Review the concept of primary resistance, the tools used to describe this phenomenon, and the challenges involved in studying it
- Discuss how molecular mechanisms of resistance to nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, and protease inhibitors translate to concepts with clinical relevance
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Role of Antiretroviral Resistance Testing in Clinical Practice
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Module 2 of 5
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CME Program Director:
John P. Phair, MD
Program Director:
Andrew R. Zolopa, MD
 
- Andrew R. Zolopa, MD
- Daniel R. Kuritzkes, MD
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Andrew R. Zolopa, MD, and Daniel R. Kurtizkes, MD, outline the indications and evolving uses of antiretroviral resistance assays. Learning Objectives
Upon completion of this activity, participants should be able to:
- List differences between genotypic and phenotypic resistance assays in terms of information gained on viral susceptibility
- Discuss results of prospective studies of resistance testing
- Explain what current guidelines suggest for clinical application of resistance testing
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Antiretroviral Hypersusceptibility: Genetic Basis and Clinical Significance
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Module 3 of 5
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CME Program Director:
John P. Phair, MD
Program Director:
Andrew R. Zolopa, MD
- Andrew R. Zolopa, MD
- Daniel R. Kuritzkes, MD
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Andrew R. Zolopa, MD, and Daniel R. Kuritzkes, MD, define antiretroviral hypersusceptibility and discuss how antiretroviral mutational interactions may be used to sustain response to therapy. Learning Objectives
Upon completion of this activity, participants should be able to:
- Define antiretroviral hypersusceptibility
- Describe those reverse transcriptase and protease mutations that are associated with hypersusceptibility to specific antiretroviral agents
- Discuss the association between hypersusceptibility to ≥ 1 drug in a regimen and virologic outcomes
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Strategies for Sequencing Antiretroviral Regimens: The Role of Drug Resistance
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Module 4 of 5
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CME Program Director:
John P. Phair, MD
Program Director:
Andrew R. Zolopa, MD
 
- Joseph J. Eron, Jr., MD
- Joel E. Gallant, MD, MPH
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Joseph J. Eron, Jr., MD and Joel E. Gallant, MD, MPH, summarize resistance data related to each currently available antiretroviral agent and discuss implications of these data for use in antiretroviral treatment. Learning Objectives
Upon completion of this activity, participants should be able to:
- List the mutations that have been associated with resistance to specific antiretroviral agents
- Discuss the impact of resistance patterns associated with specific agents on choice of initial antiretroviral regimen
- Describe the implications of resistance mutations for antiretroviral treatment sequencing strategies
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Algorithms and Online Tools for the Interpretation of Antiretroviral Resistance
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Module 5 of 5
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CME Program Director:
John P. Phair, MD
Program Director:
Andrew R. Zolopa, MD
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Robert W. Shafer, MD, orients the reader to various interpretation tools for antiretroviral resistance test. Learning Objectives
Upon completion of this activity, participants should be able to:
- Describe the information that may be correlated to drug resistance genotype
- Discuss some of the sources of discordance between genotypic and phenotypic test results
- List clinical implications for genotypic and phenotypic analysis
- Recount how information from genotypic interpretation systems can help in antiretroviral drug selection
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Animations
Divergent Evolutionary Pathways for HIV Drug Resistance
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This animation and others are available for use offline from the Download Library.
To download to your own computer and use for personal or teaching purposes, click here
Format: Adobe Flash | File size: 742 KB
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Pyrophosphorolysis: A Mechanism of HIV-1 Drug Resistance
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This animation and others are available for use offline from the Download Library.
To download to your own computer and use for personal or teaching purposes, click here
Format: Adobe Flash | File size: 1,977 KB
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Disclaimer: The materials published on the Clinical Care Options Web site reflect the views of the reviewers or authors of the CCO material, not those of Clinical Care Options, LLC, the CME provider, or the companies providing educational grants. The materials may discuss uses and dosages for therapeutic products that have not been approved by the United States Food and Drug Administration. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or using any therapies described in these materials.
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Jointly sponsored by Postgraduate Institute for Medicine and Clinical Care Options, LLC.
Contact Info
Supported by an unrestricted educational grant from Bristol-Myers Squibb Company.
Educational grants support only the CME-certified components of this program.
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