1. THE BODY PRO The HIV Resource for Health Professionals The Body PRO Covers the XVII International AIDS Conference (AIDS 2008) Mexico City; August 3-8, 2008 This activity is supported by educational grants from Faculty: David Wohl, M.D. Associate Professor of Medicine at the University of North Carolina at Chapel Hill Copyright © 2008 Body Health Resources Corporation. All rights reserved. This activity is jointly sponsored by Postgraduate Institute for Medicine and The Body PRO. David Wohl, M.D.

2. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 1 Faculty for This Activity David Wohl, M.D. Dr. Wohl is an associate professor of medicine at the University of North Carolina at Chapel Hill, and co-directs HIV services for the North Carolina Department of Corrections. Dr. Wohl is an investigator in the NIAID-sponsored AIDS Clinical Trials Group (ACTG) and a member of the ACTG Complications of HIV Disease Research Agenda Committee. His research focuses on metabolic and infectious complications of HIV and its therapies, as well as issues related to medication adherence and access to care -- particularly among incarcerated inmates with HIV infection. Disclosures Dr. Wohl has been a consultant for Abbott Laboratories, Tibotec and Merck & Co. He has served on speakers bureaus for Abbott, Gilead, Roche Laboratories, Bristol-Myers Squibb, Boehringer Ingelheim, Tibotec and Merck. In addition, he has received research support from Abbott, Roche and Merck.

3. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 2 HIV-Related Complications: Summary of HIV, Host and ART Effects Judith Currier. AIDS 2008; abstract WEAB0102. Reprinted with permission.

4. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 3 HEAT: Inflammatory Biomarker Analysis Results Kimberly Y. Smith et al. AIDS 2008; abstract LBPE1138. Copyright GlaxoSmithKline. Used with permission, 2008.

5. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 4 HIV-Related Complications: Where Does This Leave Us? Judith Currier. AIDS 2008; abstract WEAB0102. Reprinted with permission. ART treatment benefits outweigh risk, delaying therapy not the answer, impact of earlier treatment under study Understanding differences between ART agents is critical when we are considering treatment over decades Addressing CVD risk factors and tailoring ART regimens for individual patients pending further data Important to understand mechanism of ART risk, and the contributions of HIV –Prospective assessment of inflammatory markers in cohorts and controlled trials with patients at comparable stages of disease is a start

6. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 5 REAL: Body Fat Changes From Baseline at Week 48 Graeme Moyle et al. AIDS 2008; abstract MOPDB103. Reprinted with permission.

7. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 6 REAL: Percent Change From Baseline in Fasting Lipid Parameters at Week 48 (LOCF) Graeme Moyle et al. AIDS 2008; abstract MOPDB103. Reprinted with permission.

8. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 7 Tesamorelin: Percent Change in Visceral Adipose Tissue From Baseline to 26 Weeks Adapted from Julian Falutz et al. AIDS 2008; abstract LBPE1156. Visceral Adipose Tissue (%) P < 0.001 Data are mean ± SEM. P < 0.001 versus placebo.

9. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 8 Tesamorelin: Changes From Baseline in Lipid Parameters at Week 26 of Treatment Data are mean ± SEM. *P < 0.05 versus baseline; † P < 0.01 versus baseline ParametersReference Values Placebo (N = 126) Tesamorelin (N = 270) HDL Cholesterol (mmol/L)0.9 – 1.6 mmol/L Baseline1.16 ± 0.031.13 ± 0.02 Week 261.16 ± 0.041.13 ± 0.02 Change-0.0 ± 0.020.01 ± 0.01 Total Cholesterol (mmol/L)< 5.2 mmol/L Baseline4.91 ± 0.094.93 ± 0.07 Week 265.05 ± 0.094.97 ± 0.07 Change0.14 ± 0.07*0.03 ± 0.05 Total Cholesterol/ HDL Cholesterol Ratio 3.5 – 5 Baseline4.61 ± 0.144.75 ± 0.1 Week 264.75 ± 0.154.70 ± 0.09 Change0.15 ± 0.08-0.05 ± 0.06 Triglycerides (mmol/L)< 2.3 mmol/L Baseline2.52 ± 0.152.70 ± 0.18 Week 262.55 ± 0.152.45 ± 0.16 Change0.04 ± 0.11-0.25 ± 0.09 † Adapted from Julian Falutz et al. AIDS 2008; abstract LBPE1156.

10. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 9 Study 1066: Trial Design Adapted from David M. Simpson et al. AIDS 2008; abstract THAB0301. One to Two Week Screening Baseline Before Randomization 12 Weeks of Maintenance Doses* One Week Taper or Enter Open Label Placebo Four Days Fixed Dose* PGB 150 mg/Day Two Weeks of Dose Adjustment 10 Days of Flexible Dosing* 150 – 600 mg/Day Option to Change Dose* 300 mg/Day 150 or 600 mg/Day 150, 300 or 600 mg/Day *All doses given BID

11. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 10 Study 1066: Responder Rate ≥ 50 Percent Decrease in Pain Score Percent of Patients Time (Weeks) Last Observation Carried Forward (N = 149) Mean Pregabalin Dose = 386 mg/Day NS at All Timepoints Adapted from David M. Simpson. AIDS 2008; abstract THAB0301. (N = 150)

12. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 11 Study 1066: Patient Global Impression of Change Adapted from David M. Simpson et al. AIDS 2008; abstract THAB0301. Significant difference between treatment groups (P = 0.0077). Measured on a seven-point scale, condensed to three categories. *N = 149; **N = 150 Mean pregabalin dose = 386 mg/day

13. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 12 Study 1066: Treatment-Emergent Adverse Events (All Causalities) ≥ 5 Percent in Pregabalin Group and > Placebo *URT = upper respiratory tract Adapted from David M. Simpson et al. AIDS 2008; abstract THAB0301.

14. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 13 Psychiatric Comorbidity: Depression Measures at Time of HCV Treatment Initiation Adapted from Jeffrey Weiss et al. AIDS 2008; abstract WEPE0175. Beck Depression Inventory Mean Score Hamilton Depression Scale Mean Score Total Sample 9.16.6 HIV/HCV 6.1*4.6 † HCV 11.5*8.1 † *P = 0.02 † P = 0.01

15. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 14 Perinatal Transmission of HIV-1 and HCV in Infants Born to HIV-1 and HCV Infected Mothers HIV-1 Infected Pregnant Women N = 1,887 Anti-HCV Positive N = 812 (43%) Anti-HCV Negative N = 1,075 (57%) I Anti-HIV+ Anti-HCV– HIV PHK+ HCV PHK– II Anti-HIV+ Anti-HCV+ HIV PHK+ HCV PHK+ III Anti-HIV– Anti-HCV+ HIV PHK– HCV PHK+ IV Anti-HIV– Anti-HCV– HIV PHK– HCV PHK– I Anti-HIV+ Anti-HCV– HIV PHK+ HCV PHK– IV Anti-HIV– Anti-HCV– HIV PHK– HCV PHK– Number of Infants 36537564879996 Infant Status HIV+ (11%) HCV+ (9.2%) Healthy (79.8%) HIV+ (7.3%) Healthy (92.7%) Adapted from I Simonova et al. AIDS 2008; abstract WEPE0176.

16. The Body PRO New Insights on HIV/HAART Complications & Coinfections: Highlights From AIDS 2008 15 Visit The Body PRO for comprehensive coverage of AIDS 2008. This presentation was created to accompany The Body PRO's summaries of key research presented at AIDS 2008, by David Wohl, M.D. Learn more at: TheBodyPRO.com/AIDS2008 In addition, be sure to browse through The Body PRO's extensive coverage of AIDS 2008, which includes: –Summaries and analyses of research on a wide array of clinical subjects. –Interviews with top researchers discussing the results of noteworthy studies. –Audio podcasts you can play online or download to your computer or MP3 player. –Narrated, online slide presentations highlighting major study results. Visit TheBodyPRO.com/AIDS2008 today for a full listing of our conference materials!