3rd International Workshop on HIV Drug Resistance & Treatment Strategies

23-26 June 1999, San Diego, California, USA


Session 1: New antiretrovirals
Abstracts 1 thru 19, Pages 3 to 14
1 INHIBITORS OF HIV INTEGRASE: ANTIVIRAL ACTIVITY AND MECHANISM
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DJ Hazuda
The HIV-1 enzyme integrase represents a potential target for the development of selective antiretroviral agents. We have identified novel inhibitors of integrase that block integration and inhibit HIV-1 replication in cells. The isolation and characterization of resistant viral isolates has established integrase as the specific target of inhibition thus validating integrase as a viable target for chemotherapeutic intervention.
2 ANTI-HIV ACTIVITY AND CROSS-RESISTANCE PROFILE OF NOVEL 2'-FLUORO-2',3'-UNSATURATED D- AND L-NUCLEOSIDES (D4N)
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RF Schinazi1, S Schlueter-Wirtz1, P Tharnish1, D Joiner1, T Barnett1, K Lee2, YS Choi2 and CK Chu2
We recently identified D-D4FC as a highly potent and selective inhibitor of HIV-1 and HIV-2 with a unique cross-resistance profile. However, certain d4N are unstable under acidic conditions. We reasoned that introducing a vinylic fluoride moiety into the D- and L-nucleosides should eliminate this potential problem. The strategy for the synthesis of more than 30 analogues was based on direct coupling of the sugar moiety with a variety of heterocycles to obtain our target compounds.
3 THE NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR DAPD IS ACTIVE AGAINST RESISTANT HIV-1 ISOLATES FROM PATIENTS FAILING STANDARD NUCLEOSIDE THERAPY
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K Borroto-Esoda, J Mewshaw, D Wakefield, B Hooper, J Jeffrey, P Furman and B McCreedy
DAPD, (–)-β-D-2,6-diaminopurine dioxolane, is a nucleoside reverse transcriptase inhibitor (NRTI) with activity against HIV-1 and hepatitis B virus. DAPD is deaminated in vivo by adenosine deaminase to give (–)- β-D-dioxolane guanine (DXG). Biochemical analysis of the 5' triphosphates of DAPD and DXG demonstrated that DXG 5'-triphosphate is a potent inhibitor of the HIV RT with a Ki of 0.019 µM.
4 COMBINATION ANTI-HIV AND RESISTANCE PROFILES FOR SJ-3366: A NEW NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR OF HIV-1 WITH ACTIVITY AGAINST HIV-2
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RW Buckheit Jr1, TL Stup1, V Fliakas-Boltz1, JM Russell1, J-W Lee2, S-H Lee2, J-W Oh2, H-S Kwon2, S-G Chung2 and E-H Cho2
We have identified and characterized a potent new non-nucleoside reverse transcriptase (RT) inhibitor of HIV-1 that also is inhibitory against HIV-2. SJ-3366 inhibits HIV-1 replication at concentrations below 1 nM with a therapeutic index of greater than 4,000,000. SJ-3366 inhibited HIV-2 at a concentration of approximately 150 nM with a therapeutic index of nearly 20,000.
5 TIPRANAVIR IS ACTIVE AGAINST A LARGE SELECTION OF HIGHLY PROTEASE INHIBITOR-RESISTANT HIV-1 CLINICAL SAMPLES
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B Larder1, S Bloor1, K Hertogs2, C Van Den Eynde2, W DeCian3, Y Wang4 and W Freimuth4
Treatment with HIV protease inhibitors (PIs) can lead to class cross-resistance, rendering all current PIs less effective. Since considerable numbers of patients failing HAART harbour PI-resistant virus, the development of new PIs active against these variants is an urgent priority. Unlike all available PIs, tipranavir is a new non-peptidic PI that binds in a flexible manner to the protease active site, making it potentially active against HIV resistant to all approved peptidic PIs.
6 KINETIC CHARACTERIZATION OF RS-344, AN HIV-1 PROTEASE INHIBITOR DESIGNED WITH A 'RESISTANT REPELLENT' CORE
Antiviral Therapy 1999;4 (Suppl 1):5
L Suvorov, S Gulnik, E Gustchina, B Yu, R Randad, M Eissenstat and J Erickson
Despite the current success in HIV treatment with protease inhibitors, the emergence of resistant virus strains limits effectiveness of such compounds. The acquisition of mutations in HIV protease, especially in the active site regions, resulted in a high degree of cross-resistance towards many different protease inhibitors, including all clinically approved drugs. Using structure-based approaches a novel flexible core was designed to target some of the active site mutants. Using a continuous fluorogenic assay, we measured the inhibition constants for one such inhibitor, RS-344, towards wild-type and seven different drug-resistant mutant enzymes.
7 ABT-378/RITONAVIR (ABT-378R) IN PROTEASE INHIBITOR-EXPERIENCED HIV-INFECTED PATIENTS: PRELIMINARY 24 WEEK RESULTS
Antiviral Therapy 1999;4 (Suppl 1):6
C Benson2, S Brun1, Y Xu1, K Orth1, S Deeks3, H Kessler4, R Murphy5, D Wheeler6, C Hicks7, J Eron8, J Feinberg9, R Gulick10, P Sax11, R Stryker12, S Riddler13, M Thompson14, M King1, C Fields1, A Potthoff1, B Bernstein1, A Hsu1, R Bertz1, A Molla1, H Mo1, D Kempf1, E Sun1 and A Japour1
ABT-378/r is well tolerated and has antiretroviral activity among patients who experienced virological rebound following treatment with a single PI-based triple regimen.
8 ANALYSIS OF VIROLOGICAL RESPONSE TO ABT-378/RITONAVIR THERAPY IN PROTEASE INHIBITOR-EXPERIENCED PATIENTS WITH RESPECT TO BASELINE VIRAL PHENOTYPE AND GENOTYPE
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D Kempf1, H Mo1, S Brun1, A Molla1, B Bernstein1, K Hertogs2, B Larder3, K Orth1, C Fields1, M King1, Y Xu1, A Japour1, E Sun1 and the M97-765 Study Team
Because of high and sustained plasma levels, ABT-378/ritonavir regimens suppress VL in many PI-experienced patients for ≥24 weeks despite significant resistance to PIs and RTIs. However, virological response in this population is lower than in naive patients. The use of accompanying agents expected to have activity, in addition to ABT378/ritonavir, is likely to be necessary for a durable antiretroviral response.
9 HIV-1 RESISTANCE TO BINDING/FUSION INHIBITORS
Antiviral Therapy 1999;4 (Suppl 1):7
JA Esté1 and E De Clercq2
The replicative cycle of HIV can be interrupted at several stages. The reverse transcriptase (RT) and protease are the enzymes currently targeted by approved antiretroviral agents.
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Session 2: Mechanisms of antiretroviral resistance
Abstract 20 thru 57, Pages 15 to 38
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Session 3: Relationship between phenotype, genotype, and clinical response
Abstracts 58 thru 107, Pages 39 to 72
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Session 4: Combination therapy and transmission
Abstracts 108 thru 118, Pages 73 to 82
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Session 5A: Prevalence and transmission of drug resistance HIV
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C Piketty1, A Trylesinski2, A Hill3, G Peytavin4, E Race4, A Si-Mohamed1, F Clavel4 and MD Kazatchkine1
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Session 5: Pathogenesis and dynamics
Abstracts 126 thru 149, Pages 83 to 104
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Session 6: Immune reconstitution
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Session 7: Long-term suppression/eradication
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