Key HIV Research From ICAAC 2007: Antiretrovirals in Development and Salvage Faculty: Chicago, Illinois | September 17-20, 2007 This activity is supported by an.
Download ReportTranscript Key HIV Research From ICAAC 2007: Antiretrovirals in Development and Salvage Faculty: Chicago, Illinois | September 17-20, 2007 This activity is supported by an.
Key HIV Research From ICAAC 2007: Antiretrovirals in Development and Salvage 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 The Body PRO 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: Antiretrovirals in Development and Salvage Eric Daar, M.D. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO 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 CME/CE program, please visit us on the Web at: TheBodyPRO.com/ICAAC2007 • Please feel free to use this slide presentation for personal reference or for your own presentations; however, we ask that you not modify any aspects of the slides contained within this presentation, so proper attribution can be retained. If you would like to publish all or part of this presentation, or repost any of these slides online, permission must first be obtained from Body Health Resources Corporation. • Our gratitude goes out to all who granted permission for their slides to be adapted for this presentation. Disclaimer Knowledge about HIV changes rapidly. Note the date of this presentation's publication, and before treating patients or employing any therapies described in these materials, verify all information independently. If you are a patient, please consult a doctor or other medical professional before acting on any of the information presented in this presentation. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO Antiretrovirals in Development for Treatment-Experienced Patients ICAAC 2007: Antiretrovirals in Development and Salvage Antiretrovirals in Advanced Development The Body PRO Drug Name Class Development Stage Notes elvitegravir (GS-9137, JTK-303) Integrase inhibitor Phase II • Regimens including boosted PIs could have greater antiviral activity. • No clinically relevant drug interaction with etravirine. • When boosted, increases maraviroc exposure. • Showed synergistic interactions with enfuvirtide (T20, Fuzeon), darunavir (TMC114, Prezista) and efavirenz (Sustiva, Stocrin) in vitro. etravirine (TMC125) NNRTI Phase III • No clinically relevant drug interaction with elvitegravir. maraviroc (Selzentry) CCR5 inhibitor Phase III • Patients failing regimen had higher mean CD4 increases even with D/M or X4-tropic virus. • Exposure increases when used with boosted elvitegravir; use reduced dose of 150mg twice daily. raltegravir (MK0518) Integrase inhibitor Phase III • In patients with limited treatment options, all doses had potent and durable effects. vicriviroc (SCH 417690, SCH-D) CCR5 inhibitor Phase II • No adverse effect on white blood cell counts. • Not associated with an increased risk of infections. ICAAC 2007: Antiretrovirals in Development and Salvage DUET: Study Design and Major Inclusion Criteria The Body PRO Screening 6 weeks 48-week treatment period with optional 48-week extension Follow up 4 weeks 24-week primary analysis TMC125 + BR* 600 patients target per trial Placebo + BR* *BR = darunavir/ritonavir with optimised NRTIs and optional enfuvirtide • DUET-1 and -2 differed only in geographical location; pooled analysis was pre-specified • Plasma viral load >5,000 HIV-1 RNA copies/mL and stable therapy for ≥8 weeks • ≥1 NNRTI RAM, at screening or in documented historical genotype • ≥3 primary PI mutations at screening • Patients recruited from Thailand, Australia, Europe and the Americas BR = background regimen; RAM = resistance-associated mutation Pedro Cahn et al. ICAAC 2007; abstract H-717. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage DUET: Viral Load Reduction From Baseline (ITT NC=F) The Body PRO Mean change in viral load from baseline (log10 copies/mL) ± SE 0.0 TMC125 + BR (n=599) Placebo + BR (n=604) –0.5 –1.0 p<0.0001 –1.5 –1.7 –2.0 –2.4 –2.5 –3.0 –3.5 0 4 8 12 16 20 24 Time (weeks) BR = background regimen; SE = standard error; ITT = intent-to-treat population; NC=F = noncompleter equals failure imputation algorithm; changes below the detection limit (<50 copies/mL) were imputed as 49 copies/mL Pedro Cahn et al. ICAAC 2007; abstract H-717. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage DUET: Change in CD4 Cell Count From Baseline (ITT NC=F) Mean change in CD4 cell count from baseline (cells/mm3) ± SE The Body PRO 100 +86 75 +67 p<0.0001 50 25 TMC125 + BR (n=599) Placebo + BR (n=604) 0 0 4 8 12 Time (weeks) 16 20 24 BR = background regimen; SE = standard error; ITT = intent-to-treat population; NC=F = noncompleter equals failure imputation algorithm Pedro Cahn et al. ICAAC 2007; abstract H-717. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO DUET: Response (<50 copies/mL) According to Enfuvirtide (ENF) Use (Primary Analysis) Patients with viral load <50 copies/mL at Week 24 (%) TMC125 + BR (n=599) p<0.0001 p=0.427 Placebo + BR (n=604) p<0.05 73% 80 67% 62% 62% 56% 60 Using de novo ENF DRV FC category, % 34% 40 20 0 Adjusted for differences in baseline DRV FC between groups Unadjusted response rates Re-using or not using ENF Using de novo ENF TMC125 + BR Placebo + BR <2 20 27 2–10 40 39 10–40 26 26 >40 15 8 DRV = darunavir FC = baseline fold change Using de novo ENF Pedro Cahn et al. ICAAC 2007; abstract H-717. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage DUET: Response (<50 copies/mL) According to Number of Active Background Antiretrovirals The Body PRO Number of fully active background ARVs (PSS) TMC125 + BR (n=545) 45% 40/88 0 7/91 Placebo + BR (n=559) 8%a 60% 120/199 1 30% 63/211 74% 67% 191/258 ≥2 171/257 0 20 40 60 80 100 Patients with viral load <50 copies/mL at Week 24 (%) Analysis excludes patients who discontinued except for virological failure; PSS = phenotypic sensitivity score; darunavir and enfuvirtide are counted as fully active if FC<10 or used de novo, respectively Pedro Cahn et al. ICAAC 2007; abstract H-717. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage DUET: Conclusions The Body PRO • In treatment-experienced patients, including those with NNRTI resistant virus, TMC125 consistently demonstrated superiority over placebo – 59% of patients achieved confirmed undetectable VL (<50 copies/mL) with TMC125 plus BR at Week 24 • Even in the absence of any other fully active background agents, with TMC125, 45% of patients achieved undetectable (<50 copies/mL) viral load – response rates increased as more active agents were used in the background regimen • 13 TMC125 resistance-associated mutations (TMC125 RAMs) were identified – the greatest added benefit in the TMC125 versus placebo group was seen in patients with <3 TMC125 RAMs – 86% patients had <3 TMC125 RAMs • Except for rash, incidence and severity of AEs with TMC125 were similar to placebo • TMC125 has the ability to extend and enhance the NNRTI class and provide a new treatment option for patients with resistance to other NNRTIs Pedro Cahn et al. ICAAC 2007; abstract H-717. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage Protocol 004: Study Design The Body PRO Interim Analysis of Part I Before Initiating Part II Part I Part II Integrase Monotherapy for 10 Days ~ 8 pts Raltegravir 600 mg BID ~ 8 pts Raltegravir 400 mg BID ~ 8 pts Raltegravir 200 mg BID ~ 8 pts Raltegravir 100 mg BID ~ 8 pts Placebo BID Part I cohort: Rx-naive patients stratified and randomized to integrase monotherapy or placebo for 10 days Total Combination Therapy ~ 30 pts ~ 30 pts ~ 30 pts ~ 30 pts ~ 30 pts Raltegravir 600 mg BID + TDF/3TC ~ 38 pts Raltegravir 400 mg BID + TDF/3TC ~ 38 pts Raltegravir 200 mg BID + TDF/3TC ~ 38 pts Raltegravir 100 mg BID + TDF/3TC ~ 38 pts Efavirenz 600 mg QD + TDF/3TC ~ 38 pts Part II cohort: Rx-naive patients stratified and randomized to combination therapy for 48 weeks Adapted from Martin Markowitz et al. IAS 2007; abstract TUAB104. ICAAC 2007: Antiretrovirals in Development and Salvage Protocol 005: Study Design The Body PRO Weeks 1-24 Weeks 25-48 Raltegravir 200 mg BID* (43) Raltegravir 400 mg BID* (45) Raltegravir 400 mg BID* (178) Raltegravir 600 mg BID* (45) Placebo BID* (45) All 178 HIV-infected participants had an HIV RNA > 5,000 copies/mL and documented resistance to three classes of oral ARTs at baseline. *All patients received optimized background therapy. Adapted from Beatrice Grinsztejn et al. ICAAC 2007; abstract H-713. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO Protocol 005: Patient and Optimized Background Therapy (OBT) Characteristics Raltegravir (MK-0518) + OBT Placebo + OBT 200 mg 400 mg 600 mg N = 43 N = 45 N = 45 N = 45 Percentage Male 84 89 91 89 Median Age in Years 43 43 44 43 Median Years of Prior Antiretrovirals 10 11 9 10 Mean CD4 Count in mm3 245 221 220 274 Mean HIV RNA in log10copies/mL 4.6 4.8 4.7 4.7 4 4 4 4 Phenotypic Sensitivity Score*: 0 to Protease Inhibitors 42 (98%) 42 (93%) 40 (89%) 38 (84%) Phenotypic Sensitivity Score*: 0 to All Antiretrovirals 20 (47%) 26 (58%) 22 (49%) 18 (40%) Genotypic Sensitivity Score*: 0 to All Antiretrovirals 27 (63%) 38 (84%) 35 (78%) 28 (62%) Number of Patients With Enfuvirtide (T-20, Fuzeon) as New OBT 13 (30%) 8 (18%) 13 (29%) 10 (22%) OBT: Median Number of Antiretrovirals *By Phenosense GT Note: Enfuvirtide is not included in the phenotypic sensitivity score since there is no clinical cut-off. Adapted from Beatrice Grinsztejn et al. ICAAC 2007; abstract H-713. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO Protocol 005: Time to Loss of Virologic Response to Week 72: Raltegravir (MK0518) All Doses Combined vs. Placebo % of Patients Remaining HIV RNA <400 copies/mL 100 80 Raltegravir All Doses Combined 60 40 20 Placebo Placebo 0 02 4 8 12 16 24 32 40 Week 48 56 64 72 100 8 95 6 86 5 69 4 43 3 12 1 # of Patients at Risk Raltegravir All Doses Combined* 133122 122 122 120 113 Placebo* 45 11 11 11 9 9 92 5 * Plus optimized background therapy. Patients who never achieved HIV RNA <400 copies/mL were considered failures. Non-responders assigned failure at time 0. Adapted from Beatrice Grinsztejn et al. ICAAC 2007; abstract H-713. ICAAC 2007: Antiretrovirals in Development and Salvage Protocol 005: Analysis of Raltegravir (MK-0518) Resistance The Body PRO Study found no association between dose and/or drug concentration and resistance. The factors decreasing likelihood of developing mutations at amino acids 148 alone, 155 alone, and either 148 or 155 were found to be: • Phenotypic sensitivity score > 0. • Lower viral load (≤ 100,000 copies/mL vs. > 100,000 copies/mL). • New use of enfuvirtide (T-20, Fuzeon) in optimized background therapy. From: Hazuda et al, XVI International HIV Drug Resistance Workshop, 2007, Barbados Adapted from Beatrice Grinsztejn et al. ICAAC 2007; abstract H-713. ICAAC 2007: Antiretrovirals in Development and Salvage Protocol 005: Safety During Double-Blind Study Period The Body PRO Raltegravir (MK-0518) safety profile for all doses similar to placebo Liver function test abnormalities were uncommon • No grade 4 abnormalities for aspartate aminotransferase (AST), alanine transaminase (ALT) or alkaline phosphatase (ALP) • Grade 3 AST: 2/133 patients (1.5%) in all MK-0518 groups • Grade 3 ALT: 1/133 patients (0.8%) in all MK-0518 groups Most clinical adverse events (AEs) were mild to moderate 4 serious, drug-related clinical AEs • Acute pancreatitis after 2 doses, considered 2º to optimized background therapy (200 mg group) • Metabolic acidosis and renal insufficiency; sepsis; death (600 mg group) • Lacunar infarction by CT (placebo) • Worsening lipoatrophy (placebo) 2 discontinuations due to drug-related AE • Elevated AST/ALT, considered 2º to optimized background therapy (200 mg group) • Lipoatrophy (placebo) Adapted from Beatrice Grinsztejn et al. ICAAC 2007; abstract H-713. ICAAC 2007: Antiretrovirals in Development and Salvage Elvitegravir (EVG) Phase 2 Study Schema The Body PRO Andrew Zolopa et al. ICAAC 2007; abstract H-714. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO Elvitegravir Study: HIV RNA < 50 copies/mL at Week 16 for Patients With First Use of T-20 Andrew Zolopa et al. ICAAC 2007; abstract H-714. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO Week 16 HIV RNA < 50 copies/mL for Patients Receiving EVG/r 125 mg: Impact of Gradations in Activity of Optimized Background Therapy Andrew Zolopa et al. ICAAC 2007; abstract H-714. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage MOTIVATE 1 and 2: Summary of Week 24 Efficacy Results The Body PRO Includes all patients who received at least one dose of study medication P<0.001* Difference: +51 (95% CI: 33, 69) MVC QD + OBT (N=414) MVC BID + OBT (N=426) 100 90 80 70 60 50 40 30 20 10 0 P<0.0001* 44 P<0.0001* 45 23 HIV-1 RNA <50 copies/mL† † Mean change from baseline in CD4 count (cells/mm3) Patients (%) OBT alone (N=209) 120 109 P<0.001* Difference: +49 (95% CI: 31, 67) 106 100 80 60 57 40 20 0 Mean Change from Baseline in CD4 Count‡ * versus OBT alone HIV-1 RNA value imputed as baseline if missing or if patient discontinued before 24 weeks ‡ Last observation carried forward Elna van der Ryst et al. ICAAC 2007; abstract H-715. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO Characterization of Maraviroc Resistance in MOTIVATE 1 and 2: Study Overview OBJECTIVE: To study changes in HIV-1 tropism in patients who experienced treatment failure in the MOTIVATE 1 and 2 studies MOTIVATE 1 and MOTIVATE 2 Phase 3 studies in treatment-experienced patients (N=1,075) Tropism determined for all patients at screening, baseline, and all visits where VL>500 c/mL (Trofile™ assay, Monogram Biosciences) R5* Only CCR5-tropic virus detected X4† Only CXCR4-tropic virus detected D/M*† Dual/mixed tropic virus population NR/NP Non-reportable/ non-phenotypable Assessment of CD4 count at failure, time of failure, and occurrence of Category C events by tropism result * CCR5-using virus; †CXCR4-using virus Elna van der Ryst et al. ICAAC 2007; abstract H-715. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO MOTIVATE 1 and 2: Viral Populations That May Exist Within a Patient A) Pure R5 X4 X X X X X X X X XX X X X X X X X X D D D D D D D D D D D D D D D D D D D D B) Mixed R R R R R R R R R R R R RR R R RR R R R Dual/mixed (D/M) tropism X R X X X X X X XX R X X R X X X XX X X X D D R X R X X X D X R R X DX X X R XD X X R D R R R R R XR R R RR R X X R R R RR R R R Elna van der Ryst et al. ICAAC 2007; abstract H-715. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO MOTIVATE 1 and 2: CXCR4-Using Clones Were Detected at Low Frequency in the Baseline Sample Patient T6 R5 DM DM DM DM DM DM R5 HIV-1 RNA (log10 copies/mL) 6 -100 R5 500 5 400 4 3 2 • CXCR4-using clones detected at baseline (7%) • No CCR5-tropic clones on treatment 1 Time Since First Administration (Day) 0 100 200 300 Lewis M et al. XVI International HIV Drug Resistance Workshop, June 2007, Abstract 56 Elna van der Ryst et al. ICAAC 2007; abstract H-715. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage 300 200 100 0 CD4 Count (cells/mm3) R5 The Body PRO MOTIVATE 1 and 2: Selective Inhibition of R5 Viruses Can Lead to a Change in Tropism Result to D/M or X4 Trofile™ (like all resistance tests) measures relative proportions (not absolute amounts) of different viruses (Panel A) Selective inhibition of a majority virus type, increases the sensitivity to detect the minor variant (Panel B) A B R RR R R RR R R RR R R RR R R RR R RRR R R RR R RRR R RRR D R RR D RRR D R RR D R RR R R RR R R RR R R RR R R RR R R RR R R RR R R RR R RRR R R RR R RRR R R RR R R RR X RRR D R RR D RRR D R RR R R RR R R RR R R RR R R5 MVC D D D D X D D D D/M Elna van der Ryst et al. ICAAC 2007; abstract H-715. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO MOTIVATE 1 and 2: Selective Inhibition of R5 Viruses Can Lead to a Change in Tropism Result to D/M or X4 • Maraviroc selectively inhibits R5 virus • If maraviroc is administered as part of a sub-optimal regimen, pre-existing low (undetected) levels of D/M or X4 virus will emerge as the dominant viral population • Since the D/M or X4 virus is pre-existing, time to failure is shorter than with R5 virus (where maraviroc resistance must be selected de novo) • Similar to the rapid outgrowth of pre-existing (archived) drug-resistant virus when failed ARV therapy is reinitiated after treatment interruption • After withdrawal of maraviroc, selective pressure on R5 virus is removed, allowing R5 virus to re-emerge as the dominant population • Reversion to R5 takes approximately 16 weeks, consistent with loss of 3TC1 or enfuvirtide2 resistance after withdrawal of these ARVs 1. Deeks S, et al. J Infect Dis 2005; 192:1537-44. 2. Deeks et al. J Infect Dis 2007;195:387-91. Elna van der Ryst et al. ICAAC 2007; abstract H-715. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage MOTIVATE 1: Trial Design The Body PRO OBT* + placebo Randomization 1:2:2 N=601 OBT* + maraviroc (150 mg† QD) OBT* + maraviroc (150 mg† BID) Screening (6 weeks) Patient eligibility criteria: • R5 HIV-1 infection • HIV-1 RNA ≥5,000 copies/mL 0 24w • Stable pre-study ARV regimen, or no ARVs for ≥ 4 weeks • Resistance to and/or ≥ 6 months’ experience with ≥ one ARV from three classes (≥ two for PIs) Patients stratified by: • Enfuvirtide use in OBT • HIV-1 RNA < and ≥100,000 copies/mL at screening * OBT = optimized background therapy of 3–6 ARVs (PK boosting doses of RTV not counted as an ARV) † Patients receiving a PI (except TPV) and/or delavirdine in their OBT received 150 mg dose of MVC, all other patients received 300 mg dose of MVC Jacob P. Lalezari et al. ICAAC 2007; abstract H-718a. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage 48w The Body PRO MOTIVATE 1 – Week 48: Mean Change From Baseline in HIV-1 RNA OBT alone (N=118) Mean change in HIV-1 RNA from baseline (log10 copies/mL) Includes all patients who received at least one dose of study medication 24 0.0 Study week 48 MVC QD + OBT (N=232) MVC BID + OBT (N=235) -0.5 -1.0 -0.80 -1.03 -1.5 -2.0 -2.5 -1.82 Difference: -0.79* (97.5% CI: -1.14, -0.44) -1.66 -1.95 Difference: -0.85* (97.5% CI: -1.22, -0.49) -1.82 Difference: -1.02* (97.5% CI: -1.39, -0.66) Difference: -0.92* (97.5% CI: -1.28, -0.57) HIV-1 RNA value imputed as baseline if patient discontinued before 48 weeks *Treatment difference vs OBT alone Jacob P. Lalezari et al. ICAAC 2007; abstract H-718a. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO MOTIVATE 1 – Week 48: Percentage of Patients With Undetectable HIV-1 RNA Jacob P. Lalezari et al. ICAAC 2007; abstract H-718a. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO MOTIVATE 1 and 2: Proportion of Patients Receiving ENF With Undetectable HIV-1 RNA at Week 48 According to ENF First Use Patients (%) OBT alone N= 100 90 80 70 60 50 40 30 20 10 0 Maraviroc QD + OBT Maraviroc BID + OBT <400 copies/mL 71 <50 copies/mL 71 64 61 43 36 35 32 27 3 25 3 59 91 108 30 75 72 ENF first use ENF experienced/ resistance 59 91 108 30 75 72 ENF first use ENF experienced/ resistance Last observation carried forward Jacob P. Lalezari et al. ICAAC 2007; abstract H-718a. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage The Body PRO MOTIVATE 1 and 2 – Week 48: Change in CD4+ Cell Count From Baseline by Tropism Result at Time of Failure Mean change from baseline in CD4+ count in patients with treatment failure (cells/mm3 ) OBT alone N=271 MVC QD + OBT N=477 MVC BID + OBT N=487 All treatment failures* +24 (n=111) +64 (n=92) +74 (n=96) R5→ R5 +25 (n=89) +77 (n=33) +133 (n=24) R5→ D/M or X4 +61 (n=6) +47 (n=35) +57 (n=41) Tropism result, Baseline→ Treatment Failure * Includes patients with non-reportable/non-phenotypable tropism result at baseline and patients with non-reportable/non-phenotypable/missing tropism result at time of failure Jacob P. Lalezari et al. ICAAC 2007; abstract H-718a. Reprinted with permission. ICAAC 2007: Antiretrovirals in Development and Salvage ICAAC 2007: Antiretrovirals in Development and Salvage 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 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 • 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: Antiretrovirals in Development and Salvage