8th International Workshop on Clinical Pharmacology of HIV Therapy, April 2007, Budapest, Hungary
Jennifer J. Kiser, Courtney V. Fletcher, for NATAP.org
It is not possible to cover all of the abstracts presented at the Workshop, so we have chosen to focus on studies we felt were well designed and most clinically relevant. This report is divided into four sections:
- drug-drug interactions
- pharmacokinetic data with existing antiretrovirals
- antiretroviral pharmacokinetics in special patient populations
- pharmacology of investigational drugs
The 8th International Workshop on Clinical Pharmacology of HIV Therapy was held April 16-18, 2007 in Budapest, Hungary. 193 HIV clinical pharmacologists attended this years Workshop and more than half were new attendees. This years meeting included 80 posters, 30 platform presentations, six invited lectures, and a roundtable discussion on the optimal design of drug interaction studies.
The plenary lectures covered a variety of topics of relevance to clinical pharmacology and the therapeutics of treating HIV infection.
Dr. Kevin Park reminded the audience of the high frequency of drug-induced adverse reactions and their consequences including hospital admissions and drug withdrawals from the market, and discussed mechanisms of drug-induced hepatotoxicity.
Dr. Judith Currier gave a state of the art lecture on womens health topics in HIV focusing on virologic, pharmacologic and complication of treatment issues. Dr. Currier noted that to date most clinical trials are underpowered to detect differences with respect to safety and efficacy between men and women and the need for future studies to address this problem.
Dr. Daria Hazuda discussed the development of integrase inhibitors and illustrated the promise these agents hold for treatment of HIV infection.
Dr. Anton Pozniaks lecture focused on treatment and drug-drug interactions in the setting of HIV and tuberculosis co-infection. This lecture dealt with the sober statistics of infection with tuberculosis, noting one death from tuberculosis every 15-20 seconds, questions of when to start antiretroviral therapy in the co-infected person, and the management challenges of drug-drug interactions. There remain critical gaps in our understanding of the pharmacotherapy of HIV and tuberculosis coinfection that need urgent attention.
Dr. Terry Blaschke discussed a variety of issues related to the co-formulation of antiretroviral agents noting the usefulness of co-formulated drugs and the variety of challenges that must be addressed in their development.
The last lecture, given by Dr. Bruno Stieger discussed the role of membrane transporters in drug pharmacokinetics and pharmacodynamics. This is a topic of increasing importance for antiretroviral agents, with drug-drug interactions such as those between rosuvastatin and lopinavir/ritonavir, and pravastatin and darunavir/ritonavir (discussed later) likely being transporter mediated.
Drs. Thomas Kakuda and Courtney Fletcher led a roundtable discussion on the role of phenotyping cocktails to identify drug interactions, the optimal design of drug-drug interaction studies, and the importance of determining which drug-drug interactions may be of clinical significance for patients.