1. Key HIV Research From ICAAC 2007: Complications of HIV/HAART Chicago, Illinois | September 17-20, 2007 Faculty: Cal Cohen, M.D., M.S. Eric Daar, M.D. This activity is supported by an educational grant from:

2. The Body PRO ICAAC 2007: Complications of HIV/HAART Cal Cohen, M.D., M.S. Eric Daar, M.D. 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 California- Los 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. 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. Faculty for This Activity

3. The Body PRO ICAAC 2007: Complications of HIV/HAART ICAAC 2007: Key HIV Research 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, 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.

4. The Body PRO ICAAC 2007: Complications of HIV/HAART HIV Drug Resistance and the Complications of HIV/HAART

5. The Body PRO ICAAC 2007: Complications of HIV/HAART TITAN: Development of Primary Protease Inhibitor Mutations and NRTI Resistance- Associated Mutations Upon Virologic Failure Simon F. De Meyer et al. ICAAC 2007; abstract H-1020. Reprinted with permission.

6. The Body PRO ICAAC 2007: Complications of HIV/HAART TITAN: Loss of Susceptibility to Antiretrovirals in Virologic Failures (VFs) upon VF Simon F. De Meyer et al. ICAAC 2007; abstract H-1020. Reprinted with permission.

7. The Body PRO ICAAC 2007: Complications of HIV/HAART Genotypic Results and Virological Response After Interruption of NNRTI-Based Treatment Study Design Forty-three participants taking NNRTI-based antiretroviral therapy. Dual NRTIs were continued for 7 or 10 days after participants stopped taking nevirapine and efavirenz, respectively. Characteristics Upon Reinitiation of Antiretroviral Therapy Treatment was reinitiated a median of 5.6 (2.8-7.0) months after treatment interruption. HIV-1 genotype testing in 21 patients (49%) showed that no mutations contributed to NRTI or NNRTI resistance. Median CD4 cell count was 178 (152-214) cells/mm 3 and median HIV RNA was 5.78 (4.86-5.88) log copies/mL. Characteristics After Three and Six Months of Antiretroviral Therapy At three months, 24 (56%) patients achieved undetectable HIV RNA (<50 copies/mL) and the median CD4 cell count was 386 (224-492) cells/mm 3. At six months, 43 (100%) patients achieved undetectable HIV RNA (<50 copies/mL) and the median CD4 cell count was 419 (276-589) cells/mm 3. Adapted from Somnuek Sungkanuparph et al. ICAAC 2007; abstract H-368.

8. The Body PRO ICAAC 2007: Complications of HIV/HAART Change in cGFR: Abacavir (ABC) vs Tenofovir (TDF) Christopher Polk et al. ICAAC 2007; abstract H-383. Reprinted with permission.

9. The Body PRO ICAAC 2007: Complications of HIV/HAART Changes in Renal Function Among 10 Patients Categorized as Having “Current Renal Dysfunction” With Both Baseline and 12-Month Values, HIV Outpatient Study, November 2001 – September 2005 Benjamin Young et al. ICAAC 2007; abstract H-382. Reprinted with permission.

10. The Body PRO ICAAC 2007: Complications of HIV/HAART ACTG 5102: Lipid Metabolism Pablo Tebas et al. ICAAC 2007; abstract H-378. Reprinted with permission.

11. The Body PRO ICAAC 2007: Complications of HIV/HAART ACTG 5102: Changes in Immune Activation Pablo Tebas et al. ICAAC 2007; abstract H-378. Reprinted with permission.

12. The Body PRO ICAAC 2007: Complications of HIV/HAART CPCRA 060: Time to CD4 < 350 cells/µL, Therapy Initiation or Death Matthew B. Goetz et al. ICAAC 2007; abstract H-1027. Reprinted with permission.

13. The Body PRO ICAAC 2007: Complications of HIV/HAART Comparison of Luciferase Activity (RLUs) Between Standard and Enhanced Trofile Assays Jacqueline D. Reeves et al. ICAAC 2007; abstract H-1026. Reprinted with permission.

14. The Body PRO ICAAC 2007: Complications of HIV/HAART Sensitivity to Detect Minor CXCR4- Using Subpopulations Jacqueline D. Reeves et al. ICAAC 2007; abstract H-1026. Reprinted with permission.

15. The Body PRO ICAAC 2007: Complications of HIV/HAART V3 Loop Sequence-Based CRT Prediction Results Eric W. Stawiski et al. ICAAC 2007; abstract H-1028. Reprinted with permission.

16. The Body PRO ICAAC 2007: Complications of HIV/HAART Description of the Most Frequent Non-AIDS, Non-HAART Related (NANHR) Severe Clinical Events Tristan Ferry et al. ICAAC 2007; abstract H-1722. Reprinted with permission.

17. The Body PRO ICAAC 2007: Complications of HIV/HAART Factors Associated With the Occurrence of the 385 First NANHR Severe Clinical Events Tristan Ferry et al. ICAAC 2007; abstract H-1722. Reprinted with permission.

18. The Body PRO ICAAC 2007: Complications of HIV/HAART Incidence Rate Ratios (IRR) of Non-AIDS- Defining Malignancies (non-ADM) in HIV- Infected vs. Non-Infected Veterans in the HAART Era IRR in HIV+ Veterans Confidence Interval (95%) Overall1.61.5-1.7 Anal Cancer14.910.1-22.1 Hodgkin’s Lymphoma4.63.6-6.6 Liver Cancer2.82.2-3.5 Lung Cancer2.01.7-2.2 Total of 33,420 HIV+ and 66,840 HIV- veterans followed. Incidence rates of non-ADM per 100,000 person-years were 1,260 and 841 respectively. Adapted from Roger J. Bedimo et al. ICAAC 2007; abstract H-1721.

19. The Body PRO ICAAC 2007: Complications of HIV/HAART Re-treatment With Pegylated Interferon Plus Weight-Adjusted Ribavirin in HIV+ Patients With Chronic HCV Results Eugenia Vispo et al. ICAAC 2007; abstract H-1734. Reprinted with permission.

20. The Body PRO ICAAC 2007: Complications of HIV/HAART Three-Year Survival Data of Liver Transplant Recipients in Spain Hepatitis C Monoinfected Patients* HIV/Hepatitis C Coinfected Patients* Years After Transplant 12 81% (78%-83%) 74% (70%-76%) 69% (65%-72%) 88% (74%-94%) 75% (58%-86%) 64% (43%-79%) 3 Twelve (24%) HIV/hepatitis C coinfected and 273 (23%) hepatitis C monoinfected patients died during a median follow-up of 1.3 (0.5-2.4) years. *95% confidence intervals Adapted from José M. Miró et al. ICAAC 2007; abstract H-1732.

21. The Body PRO ICAAC 2007: Complications of HIV/HAART PROVE1: Study Design Adapted from Mark Sulkowski et al. ICAAC 2007; abstract V-1383. Group 1 20 patients Telaprevir (TVR, VX-950) 750 mg q8h Peginterferon alfa-2A 180 µg/week Ribavirin (RBV) 1,000-1,200 mg/day Group 2 80 patients Telaprevir 750 mg q8h Peginterferon alfa-2A 180 µg/week Ribavirin 1,000-1,200 mg/day Group 3 82 patients Telaprevir 750 mg q8h Peginterferon alfa-2A 180 µg/week Ribavirin 1,000-1,200 mg/day Group 4 (control) 81 patients Peginterferon alfa-2A/Ribavirin Weeks 1-12 0 Weeks Peginterferon alfa-2A with Ribavirin 12 Weeks Peginterferon alfa-2A with Ribavirin 36 Weeks Peginterferon alfa-2A with Ribavirin 36 Weeks Peginterferon alfa-2A with Ribavirin Additional Weeks and Doses Analysis performed when all patients completed 12 weeks. Samples were collected for sequencing at baseline and at each HCV RNA assessment.

22. The Body PRO ICAAC 2007: Complications of HIV/HAART PROVE1 Study Results: Undetectable HCV RNA Adapted from Mark Sulkowski et al. ICAAC 2007; abstract V-1383. Week 4 Groups 1-3* Undetectable HCV RNA (LOD 10 IU/mL) 79% Group 4 (Control) Undetectable HCV RNA (LOD 10 IU/mL) 11% Week 12 Groups 1-3* Undetectable HCV RNA (LOD 10 IU/mL) 70% Group 4 (Control) Undetectable HCV RNA (LOD 10 IU/mL) 39% All Group Results, Weeks 4 and 12 Note: Of those in groups 1-3* receiving 12 weeks of treatment, six of nine subjects with rapid virological response had undetectable HCV RNA 20 weeks after termination of treatment. * Groups 1-3 were taking telaprevir (TVR, VX-950) with peginterferon alfa-2A and ribavirin (RBV).

23. The Body PRO ICAAC 2007: Complications of HIV/HAART ICAAC 2007: Key HIV Research 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 CME/CE 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 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!