title: TMC114, a novel human immunodeficiency virus type 1 protease inhibitor active against protease inhibitor-resistant viruses, including a broad range of clinical isolates.
abstract: The purpose of this study was to characterize the antiviral activity, cytotoxicity, and mechanism of action of TMC114, a novel human immunodeficiency virus type 1 (HIV-1) protease inhibitor (PI). TMC114 exhibited potent anti-HIV activity with a 50% effective concentration (EC50) of 1 to 5 nM and a 90% effective concentration of 2.7 to 13 nM. TMC114 exhibited no cytotoxicity at concentrations up to 100 muM (selectivity index, >20,000). All viruses in a panel of 19 recombinant clinical isolates carrying multiple protease mutations and demonstrating resistance to an average of five other PIs, were susceptible to TMC114, defined as a fold change in EC50 of <4. TMC114 was also effective against the majority of 1,501 PI-resistant recombinant viruses derived from recent clinical samples, with EC50s of <10 nM for 75% of the samples. In sequential passage experiments using HIV-1 LAI, two mutations (R41T and K70E) were selected. One selected virus showed a 10-fold reduction in susceptibility to TMC114, but <10-fold reductions in susceptibility to the current PIs (atazanavir was not assessed), except saquinavir. However, when the selected mutations were introduced into a laboratory strain by site-directed mutagenesis, they had no effect on susceptibility to TMC114 or other PIs. There was no evidence of antagonism between TMC114 and any currently available PIs or reverse transcriptase inhibitors. Combinations with ritonavir, nelfinavir, and amprenavir showed some evidence of synergy. These results suggest that TMC114 is a potential candidate for the treatment of both naive and PI-experienced patients with HIV.
authors.affiliation: Tibotec, Gen De Wittelaan L 11B 3, B2800 Mechelen, Belgium.
authors.forename: Sandra
authors.initials: S
authors.lastname: De Meyer
authors.forename: Hilde
authors.initials: H
authors.lastname: Azijn
authors.forename: Dominique
authors.initials: D
authors.lastname: Surleraux
authors.forename: Dirk
authors.initials: D
authors.lastname: Jochmans
authors.forename: Abdellah
authors.initials: A
authors.lastname: Tahri
authors.forename: Rudi
authors.initials: R
authors.lastname: Pauwels
authors.forename: Piet
authors.initials: P
authors.lastname: Wigerinck
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: de Béthune
mesh_terms: D002460:Cell Line; D002478:Cells, Cultured; D000069454:Darunavir; D024882:Drug Resistance, Viral / Q000235:genetics; D017320:HIV Protease Inhibitors / Q000494:pharmacology*; D015497:HIV-1 / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D015498:HIV-2 / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000821:virology; D008826:Microbial Sensitivity Tests; D011995:Recombination, Genetic; D013449:Sulfonamides / Q000494:pharmacology*
chemical_list: D017320:HIV Protease Inhibitors; D013449:Sulfonamides; D000069454:Darunavir