Transcript Slide 1

Key HIV Research From ICAAC 2007:
Complications of HIV/HAART
Faculty:
Chicago, Illinois | September 17-20, 2007
This activity is supported by an educational grant from:
Cal Cohen,
M.D., M.S.
Eric Daar,
M.D.
Faculty for This Activity
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Cal Cohen,
M.D., M.S.
Dr. Cohen is the research director of the Community Research Initiative of
New England and teaches at Harvard Medical School in Boston, Mass. In
addition, he works as a HIV clinical management consultant and internist at
Harvard Pilgrim Health Care, Boston, Mass., and is affiliated with Harvard
Vanguard Medical Associates. Dr. Cohen was co-chair of the Scientific
Advisory Committee of amfAR community-based clinical trials network, and
served as co-principal investigator of the Harvard/BCH AIDS Clinical Trials
Unit, AIDS Clinical Trials Group. He holds appointments at Brigham and
Women's Hospital and Beth Israel Hospital, both in Boston, Mass.
Dr. Daar is the chief of HIV medicine at Harbor-UCLA Medical Center in Los
Angeles, Calif., and a professor of medicine at the University of CaliforniaLos Angeles' David Geffen School of Medicine. He has been an active HIV
physician and researcher since the 1980s; during the past three decades,
he has led dozens of studies on a vast range of HIV-related issues, with a
particular focus on coinfections and other health complications associated
with HIV and HIV treatment, including hepatitis C, metabolic complications,
cardiovascular disease and psychosocial issues such as depression.
ICAAC 2007: Complications of HIV/HAART
Eric Daar,
M.D.
ICAAC 2007: Key HIV Research
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About this slide presentation
• This presentation is one of three slide sets created to accompany The
Body PRO's podcast summary of key research presented at ICAAC
2007, featuring interviews with Cal Cohen, M.D., M.S., and Eric Daar,
M.D. To download the remaining slide sets or learn more about this,
please visit us on the Web at:
TheBodyPRO.com/ICAAC2007
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ICAAC 2007: Complications of HIV/HAART
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HIV Drug Resistance and the
Complications of HIV/HAART
ICAAC 2007: Complications of HIV/HAART
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TITAN: Development of Primary Protease
Inhibitor Mutations and NRTI ResistanceAssociated Mutations Upon Virologic Failure
Simon F. De Meyer et al. ICAAC 2007; abstract H-1020. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
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TITAN: Loss of Susceptibility to
Antiretrovirals in Virologic Failures
(VFs) upon VF
Simon F. De Meyer et al. ICAAC 2007; abstract H-1020. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
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Genotypic Results and Virological
Response After Interruption of
NNRTI-Based Treatment
Forty-three participants taking NNRTI-based antiretroviral
therapy.
Study Design
Characteristics
Upon Reinitiation
of Antiretroviral
Therapy
Characteristics
After Three and
Six Months of
Antiretroviral
Therapy
Dual NRTIs were continued for 7 or 10 days after
participants stopped taking nevirapine and efavirenz,
respectively.
Treatment was reinitiated a median of 5.6 (2.8-7.0) months
after treatment interruption.
HIV-1 genotype testing in 21 patients (49%) showed that no
mutations contributed to NRTI or NNRTI resistance.
Median CD4 cell count was 178 (152-214) cells/mm3 and
median HIV RNA was 5.78 (4.86-5.88) log copies/mL.
At three months, 24 (56%) patients achieved undetectable
HIV RNA (<50 copies/mL) and the median CD4 cell count
was 386 (224-492) cells/mm3.
At six months, 43 (100%) patients achieved undetectable
HIV RNA (<50 copies/mL) and the median CD4 cell count
was 419 (276-589) cells/mm3.
Adapted from Somnuek Sungkanuparph et al. ICAAC 2007; abstract H-368.
ICAAC 2007: Complications of HIV/HAART
Change in cGFR: Abacavir (ABC)
vs Tenofovir (TDF)
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Christopher Polk et al. ICAAC 2007; abstract H-383. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
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Changes in Renal Function Among 10 Patients
Categorized as Having “Current Renal Dysfunction”
With Both Baseline and 12-Month Values, HIV
Outpatient Study, November 2001 – September 2005
Benjamin Young et al. ICAAC 2007; abstract H-382. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
ACTG 5102: Lipid Metabolism
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Pablo Tebas et al. ICAAC 2007; abstract H-378. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
ACTG 5102: Changes in Immune
Activation
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Pablo Tebas et al. ICAAC 2007; abstract H-378. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
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CPCRA 060: Time to CD4 < 350
cells/µL, Therapy Initiation
or Death
Matthew B. Goetz et al. ICAAC 2007; abstract H-1027. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
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Comparison of Luciferase Activity
(RLUs) Between Standard and
Enhanced Trofile Assays
Jacqueline D. Reeves et al. ICAAC 2007; abstract H-1026. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
Sensitivity to Detect Minor CXCR4Using Subpopulations
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Jacqueline D. Reeves et al. ICAAC 2007; abstract H-1026. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
V3 Loop Sequence-Based CRT
Prediction Results
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Eric W. Stawiski et al. ICAAC 2007; abstract H-1028. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
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Description of the Most Frequent
Non-AIDS, Non-HAART Related
(NANHR) Severe Clinical Events
Tristan Ferry et al. ICAAC 2007; abstract H-1722. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
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Factors Associated With the
Occurrence of the 385 First
NANHR Severe Clinical Events
Tristan Ferry et al. ICAAC 2007; abstract H-1722. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
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Incidence Rate Ratios (IRR) of Non-AIDSDefining Malignancies (non-ADM) in HIVInfected vs. Non-Infected Veterans in the
HAART Era
IRR in
Confidence
HIV+ Veterans
Interval (95%)
Overall
1.6
1.5-1.7
Anal Cancer
14.9
10.1-22.1
Hodgkin’s Lymphoma
4.6
3.6-6.6
Liver Cancer
2.8
2.2-3.5
Lung Cancer
2.0
1.7-2.2
Total of 33,420 HIV+ and 66,840 HIV- veterans followed.
Incidence rates of non-ADM per 100,000 person-years were 1,260 and 841 respectively.
Adapted from Roger J. Bedimo et al. ICAAC 2007; abstract H-1721.
ICAAC 2007: Complications of HIV/HAART
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Re-treatment With Pegylated Interferon
Plus Weight-Adjusted Ribavirin in HIV+
Patients With Chronic HCV Results
Eugenia Vispo et al. ICAAC 2007; abstract H-1734. Reprinted with permission.
ICAAC 2007: Complications of HIV/HAART
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Three-Year Survival Data of
Liver Transplant Recipients in
Spain
Years After Transplant
Hepatitis C
Monoinfected
Patients*
HIV/Hepatitis C
Coinfected
Patients*
1
2
3
81%
74%
69%
(78%-83%)
(70%-76%)
(65%-72%)
88%
75%
64%
(74%-94%)
(58%-86%)
(43%-79%)
Twelve (24%) HIV/hepatitis C coinfected and 273 (23%) hepatitis C monoinfected patients
died during a median follow-up of 1.3 (0.5-2.4) years.
*95% confidence intervals
Adapted from José M. Miró et al. ICAAC 2007; abstract H-1732.
ICAAC 2007: Complications of HIV/HAART
PROVE1: Study Design
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Weeks 1-12
Group 1
Telaprevir (TVR, VX-950) 750 mg q8h
20
patients
Peginterferon alfa-2A 180 µg/week
Group 2
Telaprevir 750 mg q8h
80
patients
Peginterferon alfa-2A 180 µg/week
Group 3
Telaprevir 750 mg q8h
82
patients
Peginterferon alfa-2A 180 µg/week
Group 4
(control)
81
patients
Ribavirin (RBV) 1,000-1,200 mg/day
Ribavirin 1,000-1,200 mg/day
Ribavirin 1,000-1,200 mg/day
Additional Weeks and Doses
0 Weeks
Peginterferon alfa-2A
with Ribavirin
12 Weeks
Peginterferon alfa-2A
with Ribavirin
36 Weeks
Peginterferon alfa-2A
with Ribavirin
36 Weeks
Peginterferon alfa-2A/Ribavirin
Peginterferon alfa-2A
with Ribavirin
Adapted from Mark Sulkowski et al. ICAAC 2007; abstract V-1383.
ICAAC 2007: Complications of HIV/HAART
Analysis
performed
when all
patients
completed 12
weeks.
Samples were
collected for
sequencing at
baseline and
at each
HCV RNA
assessment.
PROVE1 Study Results:
Undetectable HCV RNA
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All Group Results, Weeks 4 and 12
Week 4
Week 12
Groups 1-3*
Undetectable HCV RNA
(LOD 10 IU/mL)
79%
Group 4 (Control)
Undetectable HCV RNA
(LOD 10 IU/mL)
11%
Groups 1-3*
Undetectable HCV RNA
(LOD 10 IU/mL)
70%
Group 4 (Control)
Undetectable HCV RNA
(LOD 10 IU/mL)
39%
Note: Of those in groups
1-3* receiving 12 weeks
of treatment, six of nine
subjects with rapid
virological response had
undetectable HCV RNA
20 weeks after
termination of treatment.
* Groups 1-3 were taking telaprevir (TVR, VX-950)
with peginterferon alfa-2A and ribavirin (RBV).
Adapted from Mark Sulkowski et al. ICAAC 2007; abstract V-1383.
ICAAC 2007: Complications of HIV/HAART
ICAAC 2007: Key HIV Research
The Body PRO
• Visit The Body PRO for Comprehensive Coverage of ICAAC 2007.
This presentation is one of three slide sets created to accompany The
Body PRO's CME/CE podcast summary of key research presented at
ICAAC 2007, featuring interviews with Cal Cohen, M.D., M.S., and Eric
Daar, M.D. To download the remaining slide sets or learn more about
this CME/CE program, please visit us on the Web at:
TheBodyPRO.com/ICAAC2007
• In addition, be sure to browse through The Body PRO’s extensive
coverage of ICAAC 2007, which includes:
– Downloadable MP3s and full transcripts
– Expert discussion of key research
– Slides and in-depth data analyses
• Visit TheBodyPRO.com/ICAAC2007 today for a full listing of our
conference materials!
ICAAC 2007: Complications of HIV/HAART