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One Size Fits One: Treating the Individual
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Webcasted Presentation
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Chair's Introduction & Welcome
Prof. José Gatell, Barcelona, Spain
 - Biography
English - 2007-10-25
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7 slide(s)
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Abstract
On behalf of the members of the symposium faculty, I would like to welcome you to Madrid and to GlaxoSmithKline’s satellite symposium here at the 11th European AIDS Conference.
HIV-treating physicians are faced with the challenge of selecting the right combination of drugs for a given patient from an increasing number of antiretroviral medications. There are many factors a physician can use to guide this treatment choice, both from a viral and patient perspective. At the level of the virus, viral load, drug resistance and co-receptor tropism all have a role in guiding physician choices. At the patient level, CD4 cell count, co-morbidities and concomitant medications will influence our therapeutic decisions, as might age, sex, weight, lifestyle and social factors. However, more recent advances in our understanding of how subtle biological differences between human beings influence pharmacotherapeutic outcomes may ultimately allow us to make choosing a drug even more specific to the individual.
Our individual genetic make-up influences a wide variety of host–drug interactions affecting exposure, efficacy and safety. The science of pharmacogenomics seeks to apply knowledge of these influences to enable us to better tailor treatment to the patient, based on their particular genetic complement. However, as with all forms of translational medicine, the route from laboratory to bedside can be long and slow, and requires more than just the knowledge that a particular gene associates with a particular outcome. Despite the inherent promise of genetically-guided drug selection, its utility in routine practice has not been well demonstrated for most applications where a pharmacogenetic influence is known. An exception to this, however, involves the immunogenetic correlates of abacavir hypersensitivity, for which a great deal of clinical and laboratory data have accumulated in the last few years.
In this symposium, Professor Jean-Michel Molina will discuss how and why the HLA-B*5701 genetic allele influences abacavir hypersensitivity and will review both the clinical data and the challenges associated with establishing the utility of pre-therapeutic genetic screening to prevent this adverse event.
Hypersensitivity to abacavir is typically an early-onset event. However, as the discipline of antiretroviral therapy matures, physicians are faced with an ageing patient population with ever-longer exposure to potent drug combinations. Dr. Carlo Torti will therefore take us beyond hypersensitivity to discuss the long-term safety and tolerability of abacavir in the context of those late-onset or cumulative toxicities that are becoming of increasing concern.
On behalf of my fellow Faculty, I hope you enjoy this programme.
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