title: Anti-human immunodeficiency virus type 1 activity of the nonnucleoside reverse transcriptase inhibitor GW678248 in combination with other antiretrovirals against clinical isolate viruses and in vitro selection for resistance.
abstract: GW678248, a novel nonnucleoside reverse transcriptase inhibitor, has been evaluated for anti-human immunodeficiency virus activity in a variety of in vitro assays against laboratory strains and clinical isolates. When GW678248 was tested in combination with approved drugs in the nucleoside and nucleotide reverse transcriptase inhibitor classes or the protease inhibitor class, the antiviral activities were either synergistic or additive. When GW678248 was tested in combination with approved drugs in the nonnucleoside reverse transcriptase inhibitor class, the antiviral activities were either additive or slightly antagonistic. Clinical isolates from antiretroviral drug-experienced patients were selected for evaluation of sensitivity to GW678248 in a recombinant virus assay. Efavirenz (EFV) and nevirapine (NVP) had > or = 10-fold increases in their 50% inhibitory concentrations (IC50s) for 85% and 98% of the 55 selected isolates, respectively, whereas GW678248 had a > or = 10-fold increase in the IC50 for only 17% of these isolates. Thus, 81 to 83% of the EFV- and/or NVP-resistant viruses from this data set were susceptible to GW678248. Virus populations resistant to GW678248 were selected by in vitro dose-escalating serial passage. Resistant progeny viruses recovered after eight passages had amino acid substitutions V106I, E138K, and P236L in the reverse transcriptase-coding region in one passage series and amino acid substitutions K102E, V106A, and P236L in a second passage series.
authors.affiliation: Department of Virology, Metabolic and Viral Diseases Center of Excellence for Drug Discovery, GlaxoSmithKline, 5 Moore Dr., P.O. Box 13398, Research Triangle Park, North Carolina 27709, USA. richard.j.hazen@gsk.com
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Hazen
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Harvey
authors.forename: Marty H
authors.initials: MH
authors.lastname: St Clair
authors.forename: Robert G
authors.initials: RG
authors.lastname: Ferris
authors.forename: George A
authors.initials: GA
authors.lastname: Freeman
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Tidwell
authors.forename: Lee T
authors.initials: LT
authors.lastname: Schaller
authors.forename: Jill R
authors.initials: JR
authors.lastname: Cowan
authors.forename: Steven A
authors.initials: SA
authors.lastname: Short
authors.forename: Karen R
authors.initials: KR
authors.lastname: Romines
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Chan
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Boone
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D019380:Anti-HIV Agents / Q000494:pharmacology*; D023241:Antiretroviral Therapy, Highly Active; D002460:Cell Line; D004305:Dose-Response Relationship, Drug; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D054303:HIV Reverse Transcriptase / Q000037:antagonists & inhibitors* / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D009570:Nitriles / Q000494:pharmacology*; D010641:Phenotype; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology*; D013449:Sulfonamides / Q000494:pharmacology*
chemical_list: D019380:Anti-HIV Agents; C506966:GW 678248; D009570:Nitriles; D018894:Reverse Transcriptase Inhibitors; D013449:Sulfonamides; D054303:HIV Reverse Transcriptase