Idenix Pharmaceuticals (IDIX)

[gofishmarko]

Some good slides on HBV resistance , etc.


From :
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention
International AIDS Society and Australasian Society
for HIV Medicine
7/23/07


Slides (pdf):

http://www.kaisernetwork.org/health_cast/uploaded_files/MOBS103-Locarnini.pdf


Transcript (pdf):

http://kaisernetwork.org/health_cast/uploaded_files/072307_ias_hep_transcript.pdf

( HBV stuff starts on p.18 -- S. Locarnini )


It's a pretty poor transcript but using the slides you can sort of follow along. It covers resistance issues and also co-selection of surface Ag / envelope variants with drug resistance.

Locarnini and his group run the SeqHepB database which now has thousands of HBV sequences from patients who have developed resistance. This sort of data will eventually be used to make treatment decisions as assays for rapid detection of resistant variants become commercially available.

He's a big believer in combo therapy , since it raises the genetic barrier to resistance , and he makes the point that entecavir , which requires 3 or more mutations for resistance , is effectively like a combo tx. , compared to all the other monotherapy drugs which only require 1 or 2 mutations.

from p.39

"...I’m a committed combination therapy person but I have to concede that yes with entecavir in naïve patients you need three mutations to generate resistance then yes, that’s actually a good way to go."



This , IMO , goes a long way towards explaining the rapid uptake of entecavir.