I see now that _ctypes is in fact in the solution, and if I open the solution in visual studio and build it manually, it gets built. Even if I just build the solution in visual studio, it gets built.
However, if I run the following command, _ctypes doesn't get built:
msbuild pcbuild.sln /p:Configuration=Release /p:Platform=x64
The output log doesn't mention "ctypes.", so it appears as if it's not attempting to build it at all.
This would work for me a week or two ago, prior to the VS2010 conversion (though I would convert the project before building), so this behavior feels a bit like a regression.