Title
Drug-Class Specific Impact of Antivirals on the Reproductive Capacity of HIV.
Abstract
Predictive markers linking drug efficacy to clinical outcome are a key component in the drug discovery and development process. In HIV infection, two different measures, viral load decay and phenotypic assays, are used to assess drug efficacy in vivo and in vitro. For the newly introduced class of integrase inhibitors, a huge discrepancy between these two measures of efficacy was observed. Hence, a thorough understanding of the relation between these two measures of drug efficacy is imperative for guiding future drug discovery and development activities in HIV. In this article, we developed a novel viral dynamics model, which allows for a mechanistic integration of the mode of action of all approved drugs and drugs in late clinical trials. Subsequently, we established a link between in vivo and in vitro measures of drug efficacy, and extract important determinants of drug efficacy in vivo. The analysis is based on a new quantity-the reproductive capacity-that represents in mathematical terms the in vivo analog of the read-out of a phenotypic assay. Our results suggest a drug-class specific impact of antivirals on the total amount of viral replication. Moreover, we showed that the (drug-)target half life, dominated by immune-system related clearance processes, is a key characteristic that affects both the emergence of resistance as well as the in vitro-in vivo correlation of efficacy measures in HIV treatment. We found that protease-and maturation inhibitors, due to their target half-life, decrease the total amount of viral replication and the emergence of resistance most efficiently.
Year
DOI
Venue
2010
10.1371/journal.pcbi.1000720
PLOS COMPUTATIONAL BIOLOGY
Keywords
Field
DocType
drug targeting,viral load,virus replication,mode of action,development process,drug discovery,virology,viral replication,drug therapy,mathematical modelling,life cycles,immune system,population biology,applied mathematics,clinical trial,pharmacology,computer simulation
Viral load,Drug class,Drug discovery,Biology,Pharmacology,Viral replication,In vivo,Integrase inhibitor,Bioinformatics,Drug,Efficacy
Journal
Volume
Issue
ISSN
6
3
1553-7358
Citations 
PageRank 
References 
7
1.03
3
Authors
3
Name
Order
Citations
PageRank
Max von Kleist192.12
Stephan Menz271.03
Wilhelm Huisinga3418.15