HTB South

Volume 5 Number 3 July-September 2012

This issue of HTB South includes the wealth of data presented before and during the 19th IAS World AIDS Conference in Washington DC in July 2012.

Our first reports from IAS 2012 focus on new antiretrovirals, regimens and strategies including the investigational integrase inhibitor dolutegravir and booster cobicistat; in vitro and animal data that might help to assuage concerns about potential toxicities with BMS-98600, which being a derivative of d4T has a hard reputation to shake off; and first observed association between atazanavir and gall stones.

There was some overlap between IAS 2012 and the excellent 4th International Workshop HIV Pediatrics preceding it so we have combined the reports from both meetings. These include the first data from infants and children receiving Cipla’s sprinkle formulation of lopinavir/ritonavir from CHAPAS-2 (supported by the Monument Trust). We have been following this development for some time and it is encouraging to see a product under investigation specifically targeting this population in resource limited settings where infants and young children badly need new options that are fit for purpose.

Two prevention studies looking at maraviroc in macaques and mechanisms for the benefit from medical male circumcision are respectively disappointing and illuminating. We also include an overview of cure research presented at the meeting – which had a high profile including an interesting satellite – and studies looking at PK of old and new TB drugs, particularly when given with ART.

Also preceding the main conference was the 14th International Workshop on Co-morbidities and Adverse Drug Reactions (IWCAR). From this we report on a study looking at proteinuria as a potential early marker of tenofovir-related renal toxicity and an ageing study showing a higher incidence of one or more co-morbiditiy plus a higher number of co-morbidities in HIV positive people compared to negative controls.

Finally, for a change of scenery for the conference coverage, we include reports from Sitges in June, where 20th International HIV Drug Resistance Workshop was held. From this meeting we have – among others – a further report of in vitro data for BMS-98600, this time showing its resistance profile, and a depressing first case report of transmission with five-class drug resistance. Plus, TAG’s Richard Jeffreys urges caution when interpreting new data on the Berlin patient presented here and provoking some misleading articles.

In the midst of all this activity, in July, the US Food and Drug Administration (FDA) approved Truvada (tenofovir/FTC) to reduce the risk of HIV infection in uninfected people who are at high risk of acquiring HIV. The first antiretroviral approval for PrEP. And TB drug development is advancing, which Nathan Geffen describes.

So, if you have a post-Olympic gap to fill there is plenty of reading to be had!

HTB South Supplements

i-Base/TAG 2012 pipeline report

Not a printed supplement this time (although some of you might have picked one up at the conference) but the annual i-Base/TAG pipeline report is now published online.

The report reveals the deepening gulf between new scientific advances that make it possible to prevent, treat, and in some cases cure people living with HIV, hepatitis C virus (HCV), and tuberculosis (TB), and access to these where they are most needed.

There are many promising new candidates in the pipeline, as Simon Collins’s chapter on adult antiretrovirals reveals, with at least 15 new drugs and combinations in phase 2 and 3 studies.

And for the paediatric HIV pipeline, Polly Clayden demonstrates that some companies have also made significant progress in more rapidly developing new antiretroviral options for children living with HIV.

Richard Jefferys covers this year’s groundbreaking FDA review of Truvada for PrEP, HIV cure research, and the ongoing challenge to discover and develop safe and effective vaccines to prevent HIV transmission.

For the hepatitis C virus (HCV) Tracy Swan and Karyn Kaplan provide a sweeping overview of the exciting developments in HCV combination therapy and cure, with over 25 direct-acting antivirals (DAAs) in development for HCV.

Tuberculosis (TB) research is also livening up, particularly in TB drugs and regimens, although hardly a revolution (unlike HCV), but Erica Lessem shows significant progress in new TB drug and regimen development.

Read the report online and download PDF format.

We have also launched a new website in partnership with TAG with search features and archives of previous reports.

This will be updated as new developments occur, in addition to the annual report. We will also be adding new materials – such as slide sets – and hope that it will be a useful new resource.

Links to other websites are current at date of posting but not maintained.