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12th International HIV Drug Resistance Workshop
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I arrived Tuesday afternoon, after a 7 hour flight, along with most of the
approximate 100 resistance researchers and clinicians that are attending this
conference. The conference is being held from June 10-14 in Los Cabos, Mexico. The
reception was Tuesday nite and presentations, both oral and posters, start at 8am
Wed June 11. The conference is at a hotel directly on the ocean. The area is
quite remote and the views of the ocean from the hotel are quite dramatic.
Telephone and internet connections are not easy here but I'll try to provide
reporting. Of note, there are a number of interesting presentations on
characterization of resistance for new drugs intended for patients with extensive protease
inhibitor and NNRTI resistance: tipranavir, TMC-114 for PI resistance, TMC-125
for NNRTI resistance, T-1249 (second generation fusion inhibitor from
Roche/Trimeris. These drugs are currently in clinical trials of phase II and III in
patients with HIV. Except for the tipranavir studies which were conducted in a
large number of patients because this drug is in phase III, the studies
conducted are small, short-term and preliminary. The data presented here on
resistance and antiviral activity for these drugs suggest preliminarily that these
drugs will be potent and effective for many patients with extensive resistance to
protease inhibitors and NNRTIs. The studies being presented here for these
drugs show viral response for patients who are resistant to PIs or NNRTIs and
the studies explain the resistance profiles of the patients showing they have
extensive drug resistance. But these drugs were effective in these patients in
reducing viral load despite extensive resistance. T-1249 was tested in
patients with resistance to T-20 (Fuzeon).
Tipranavir is in phase III and is the closest to being available. TMC-114,
TMC-125, and T-1249 are still in earlier stages of development (phase II).
There are presentations here on several drugs even in earlier stages of
development that show early promise: elvucitabine (ACH-126,443 or Fd4C) is an L
nucleoside analogue (AZT is a nucleoside analogue); a new Roche protease
inhibitor (R0033-4649); new type of protease inhibitor (P-1946) still in pre-clinical
testing.
Additional reporting and data from these studies will be forthcoming in
reports from NATAP. Andrew Zolopa, MD from Stanford University and myself will be
reporting from this conference.
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