This study compared the efficacy of efavirenz versus ritonavir-boosted protease inhibitor based initial antiretroviral therapy in patients with high plasma
The discovery of medicinal agents capable of specifically inhibiting human immunodeficiency virus (HIV) is urgently needed due to its globally widespread infection. Most of clinically useful anti-HIV agents are nucleosides but their use is limited due to their severe toxicity and emerging drug resistance. More than 50% of world marketed drugs have their origin of the nature. Natural products, of which structural diversity is so broad, are good sources for the effective discovery of anti-HIV agents with decreased toxicity. Over the past decade, substantial progress has been made in research on the natural products for the anti-HIV agents. New natural products that have potent anti-HIV activities with novel structures were reviewed in this article. These compounds, isolated mainly from medicinal plants, in this review have been classified as secondary metabolites such as terpenes, phenolics, and naturally scarce peptides and sugars. Especially, terpenes and phenol substances have gained much ...
Browsing by Title "Early antiretroviral therapy reduces the incidence of otorrhea in a randomized study of early and deferred antiretroviral therapy : evidence from the Children with HIV Early antiretroviral therapy (CHER) Study ...
TY - JOUR. T1 - Effect of class-specific therapy interruption on persistence of HIV type 1 antiretroviral resistance. AU - Campo, Rafael E.. AU - Rosa, Isabella. AU - Lichtenberger, Paola N.. AU - Suarez, German. AU - Rivera, Fernando A.. AU - Jayaweera, Dushyantha T.. AU - Rodriguez, Allan E.. AU - Wahlay, Natalie A.. AU - Kolber, Michael A.. PY - 2003/8/1. Y1 - 2003/8/1. N2 - Interruption of all antiretroviral therapy for HIV-1 infection when therapy is failing and antiretroviral resistance has emerged is frequently associated with the disappearance of detectable resistance-associated protease and reverse transcriptase substitutions. However, the effect that discontinuation of treatment with a particular antiretroviral class has on resistance to that class when other antiretroviral therapy is continued is unknown. We investigated differences in detectable genotypic resistance to protease inhibitors (PI) and nonnucleoside reverse transcriptase inhibitors (NNRTI) among two populations: patients ...
OBJECTIVES: No randomized controlled trials have yet reported an individual patient benefit of initiating combination antiretroviral therapy (cART) at CD4 counts , 350 cells/muL. It is hypothesized that earlier initiation of cART in asymptomatic and otherwise healthy individuals may lead to poorer adherence and subsequently higher rates of resistance development. METHODS: In a large cohort of HIV-positive individuals, we investigated the emergence of new resistance mutations upon virological treatment failure according to the CD4 count at the initiation of cART. RESULTS: Of 7918 included individuals, 6514 (82.3%), 996 (12.6%) and 408 (5.2%) started cART with a CD4 count ...
The purpose of this study was to find a safe and tolerable dose of the protease inhibitor (PI) atazanavir (ATV), with or without a low-dose boost of the PI ritonavir (RTV), when taken with other anti-HIV drugs in HIV infected infants, children, and adolescents.. Advancements in anti-HIV drugs for HIV infected children and adolescents have been hard to make, in part because these patients often do not take the drugs as prescribed. ATV may be a better option because it is available in the form of powder which children and adolescents may be more willing to take regularly. Using a low dose of RTV as a boosting agent for ATV may also increase the chances of virologic response of highly active antiretroviral treatment (HAART)-experienced patients. This study aimed to find safe and tolerable doses of ATV with or without low-dose RTV boost in infants, children, and adolescents. For this study, participants were enrolled in the United States and South Africa. ...
The purpose of this study was to find a safe and tolerable dose of the protease inhibitor (PI) atazanavir (ATV), with or without a low-dose boost of the PI ritonavir (RTV), when taken with other anti-HIV drugs in HIV infected infants, children, and adolescents.. Advancements in anti-HIV drugs for HIV infected children and adolescents have been hard to make, in part because these patients often do not take the drugs as prescribed. ATV may be a better option because it is available in the form of powder which children and adolescents may be more willing to take regularly. Using a low dose of RTV as a boosting agent for ATV may also increase the chances of virologic response of highly active antiretroviral treatment (HAART)-experienced patients. This study aimed to find safe and tolerable doses of ATV with or without low-dose RTV boost in infants, children, and adolescents. For this study, participants were enrolled in the United States and South Africa. ...
PRECLINICAL PHARMACOLOGICAL STUDIES OF ANTITUMOR AND ANTI-HIV AGENTS NIH GUIDE, Volume 23, Number 3, January 21, 1994 RFP AVAILABLE: NCI-CM-57199-12 P.T. 34 Keywords: Pharmacology Chemotherapeutic Agents National Cancer Institute The Developmental Therapeutics Program (DTP), Division of Cancer Treatment, is soliciting organizations having the necessary experience, scientific and technical personnel, and facilities to conduct a series of preclinical pharmacokinetic and other pharmacology studies in non-disease bearing animals on agents having demonstrated antitumor or anti-HIV activity and considered by DCT to merit further development. The studies to be performed will include: the development of methodology for the quantitative measurement of test agents and/or metabolites in animal body fluids and tissues; stability studies of test agents in biological fluids; plasma protein binding determinations; characterization of in vivo plasma concentration-time profiles and calculation of relevant ...
TY - JOUR. T1 - Outcomes of second-line antiretroviral therapy among children living with HIV. T2 - a global cohort analysis. AU - The Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration. AU - Patel, Kunjal. AU - Smith, Colette. AU - Collins, Intira Jeannie. AU - Goodall, Ruth. AU - Abrams, Elaine J.. AU - Sohn, Annette H.. AU - Mohamed, Thahira J.. AU - Van Dyke, Russell B.. AU - Rojo, Pablo. AU - Wools-Kaloustian, Kara. AU - Pinto, Jorge. AU - Edmonds, Andrew. AU - Marete, Irene. AU - Paul, Mary. AU - Nuwaqaba-Biribonwoha, Harriet. AU - Leroy, Valériane. AU - Davies, Mary Ann. AU - Vreeman, Rachel. AU - Maxwell, Nicky. AU - Timmerman, Venessa. AU - Duff, Charlotte. AU - Mofenson, Lynne. AU - Bekker, Linda Gail. AU - Vicari, Marissa. AU - Essajee, Shaffiq. AU - Penazzato, Martina. AU - Collins, Intira Jeannie. AU - Wools-Kaloustian, Kara. AU - Davies, Mary Ann. AU - Leroy, Valériane. AU - Goodall, Ruth. AU - Patel, Kunjal. AU - Smith, ...
Warning: Trizivir therapy should not be used without a NNRTI or PI unless circumstances dictate that this is the only practical therapy for a particular client. In particular patients with advanced disease or higher viral loads should be treated with an alternative regimen until further information becomes available. ...
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A new dual-therapy option, rilpivirine and darunavir (boosted by cobicistat) was tested as a switch regimen in virologically suppressed people in the randomised PROBE 2 trial conducted in Italy.. The study enrolled 160 people living with HIV who had viral load suppressed below 50 copies/ml for at least six months prior to enrolment, and no known resistance to protease inhibitors or non-nucleoside reverse transcriptase inhibitors (NNRTI). Participants were randomised to receive rilpivirine (25mg) and darunavir/cobicistat (800/100mg) once daily or to continue their existing three-drug regimen for 24 weeks, after which the three-drug group also switched to the investigational regimen.. Sixty-two per cent of the rilpivirine+darunavir group and 70% of the control group were male, participants had had undetectable viral load for a median of seven years and were taking their third antiretroviral therapy regimen at the time of randomisation. Approximately two-thirds were taking NNRTI-based therapy at ...
Both baseline CD4+ as well as HIV-1 RNA levels appeared to be strong predictors of WC change, with higher RNA levels and lower CD4+ levels being associated with higher increases in waist circumference......When examining effect measure modification by sex, the treatment difference for change in WC for ATV/r versus RAL was significantly larger for females than for males.....For modification of treatment by race/ethnicity: We found a significantly larger difference in WC change for DRV/r versus RAL for black individuals compared to all other race/ethnicities; For black individuals - larger wc increase for raltegravir (green) compared to darunavir (red); In addition, black individuals experienced a significantly smaller increase in WC for DRV/r compared to ATV/r`" ...
This trial is investigating the pharmacokinetics and efficacy of antiretroviral agents etravirine [Intelence, TMC125], emtricitabine [Emtriva, FTC], tenofovir
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High Prevalence of Drug Resistance Mutations Among Patients Failing First-Line Antiretroviral Therapy and Predictors of Virological Response 24 Weeks After Switch to Second-Line Therapy in S o Paulo State, Brazil. ...
High Prevalence of Drug Resistance Mutations Among Patients Failing First-Line Antiretroviral Therapy and Predictors of Virological Response 24 Weeks After Switch to Second-Line Therapy in S o Paulo State, Brazil. ...
Click to launch & play an online audio visual presentation by Prof. Dr. Erik De Clercq on Prospects of anti-HIV therapy and prophylaxis, part of a collection of online lectures.
Deciding when to start anti-HIV therapy and what treatments to start with can leave many people feeling overwhelmed with choices. The discussion ...
Author: Lengauer, Thomas et al.; Genre: Journal Article; Published in Print: 2006; Title: Bioinformatics-assisted anti-HIV therapy
Tenofovir is a new nucleotide reverse transcriptase inhibitor recently approved in the United States for the treatment of HIV-1 infection when taken in combination with other antiretrovirals.
ATLANTA -- For treatment-naive HIV patients with an opportunistic infection, the benefits of immediate antiretroviral therapy outweigh the risks, according to new guidelines from the CDC.
Research with human tissue and cells suggests that genetic variations, in addition to failure to comply with treatment regimens, may account for some failures of an anti-HIV drug to treat and prevent HIV infection.
The next new anti-HIV drug to be approved by the Food and Drug Administration (FDA) is likely to be darunavir (previously known as TMC-114 and soon to ...
Despite effective combination therapies that can suppress viral infection, there is an urgent need for the discovery of a new class of anti-HIV drugs...
Objective 1. To study the cumulative incidence of dyslipidemia 2. Evaluate factor relation to dyslipidemia status of patients using antiretroviral drug in Phibonmunsahan Hospital
The findings of a recent study may quiet concerns that the babies of women who are HIV-positive during pregnancy will be more prone to birth defects if the mother takes antiretroviral drugs.
hasnt fallen to undetectable levels within three to six months of starting HIV treatment, then your doctor will talk to you about your current treatment. They may ask some detailed questions about how and when you take your anti-HIV drugs and whether you have taken any other drugs - including prescription, over-the-counter, herbal or recreational drugs --- at the same time. This is because not taking treatment regularly, or interactions with other drugs, can cause the levels of anti-HIV drugs in your body to be too low to work. You may have a blood test to look at the level of anti-HIV drugs in your blood and to see if your HIV has developed resistance ...
ART regimens in patients that are virologically suppressed confers risks including emergence of resistance (i.e. risk of virologic failure), or new toxicities. A central goal of switching ART regimens is to maintain viral suppression, without jeopardizing future treatment options [bib]127[/bib]. One should consider prior documented resistance mutations, which are likely to
The inhibitor is designed to bind the HIV envelope at sites that attach to CD4 and CCR5 molecules on CD4 T cells; blocking this interaction prevents HIV ...
You searched for: Author Abrams, Elaine J. Remove constraint Author: Abrams, Elaine J. Author Broyles, Laura N. Remove constraint Author: Broyles, Laura N. Academic Unit Epidemiology Remove constraint Academic Unit: Epidemiology Type Articles Remove constraint Type: Articles Date Published 2017 Remove constraint Date Published: 2017 Subject Antiretroviral agents Remove constraint Subject: Antiretroviral agents ...
Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. You may take this medicine with or without food. Take your medicine at regular intervals. Do not take your medicine more often than directed. For your anti-HIV therapy to work as well as possible, take each dose exactly as prescribed. Do not skip doses or stop your medicine even if you feel better. Skipping doses may make the HIV virus resistant to this medicine and other medicines. Do not stop taking except on your doctors advice ...
1-(3-isopentanoyl-5-((3,5-diisopentanoyl-2,4,6-trihydroxyphenyl)-4-benzyloxyphenylmethyl)-2,4,6-trihydroxyphenyl)-3-methylbutan-1-one: has anti-HIV activity; structure in first source
BOSTON, Feb 11, 2003 (BUSINESS WIRE) --. 48-Week Data from Alize Trial Presented Today at 10th Conference on Retroviruses and Opportunistic Infections. French researchers presented new 48-week data from a Phase III clinical trial today. These data demonstrate that emtricitabine (FTC), an investigational once-daily nucleoside reverse transcriptase inhibitor (NRTI), suppresses HIV when taken as part of a once-daily, protease inhibitor (PI)-sparing antiretroviral regimen. Emtricitabine is being developed by Triangle Pharmaceuticals, which was acquired by Gilead Sciences (Nasdaq:GILD) in January 2003. Dr. Jean-Michel Molina presented the 48-week results of the ANRS 099 Alize trial (Abstract #551) at the 10th Conference on Retroviruses and Opportunistic Infections in Boston, Massachusetts. The ANRS 099 Alize trial is an ongoing three-year, open-label, multicenter study involving 355 patients who at baseline had to have HIV RNA less than 400 copies/mL while receiving PI-based antiretroviral therapy. ...
By several parameters known to be associated with HIV disease progression, children who are treated with protease inhibitor-containing antiretroviral therapy and reconstitute their CD4 T cells despite viral rebound have similar outcomes to those who optimally suppress viral replication. In our study, discordant viral and immune response outcome groups showed sustained increases in CD4 T-cell counts and displayed growth parameters, prevalence of HIV-associated illnesses, and levels of functional immunity that were equivalent to VS/IS children. The substantial restoration of CD4 T-cell counts in the VS/IS and VF/IS response groups during the initial 24 weeks of treatment was sustained over the subsequent 72 weeks in both outcome groups. The durability of CD4 reconstitution in VF/IS children who were enrolled in our study is in contrast to previous examinations of CD4 T-cell reconstitution in HIV-infected adults in which 30% to 40% of patients who displayed discordant viral and immune responses ...
The Original Study Several observational studies have reported that the early use of antiretroviral therapy by patients diagnosed with HIV decreases rates of HIV acquisition among their sexual partners. This study evaluates the impact of early antiretroviral therapy on HIV acquisition among serodiscordant couples from nine countries.
The annual Conference on Retroviruses and Opportunistic Infections (CROI) brings together top basic, translational, and clinical researchers from around the world to share the latest studies, important developments, and best research methods in the ongoing battle against HIV/AIDS and related infectious diseases. CROI is a global model of collaborative science and the premier international venue for bridging basic and clinical investigation into clinical practice in the field of HIV and related viruses.
The Botswana national treatment guidelines for adults recommend two nucleoside reverse transcriptase inhibitors (NRTIs), zidovudine/lamivudine, and one non-nucleoside reverse transcriptase inhibitor (NNRTI). Typically, the NNRTI is efavirenz or, for women of reproductive age, nevirapine. The regimen consisted of 200 mg of Combivir (lamzid, once available) twice daily. Nevirapine began with a two-week lead-in period of 200 mg once a day followed by a maintenance regimen of 200 mg twice a day. Efavirenz was dosed at 600 mg each day.. Patients experiencing virologic failure on first-line therapy were switched to a protease inhibitor-based regimen (lopinavir/ritonavir) coupled with two NRTIs (didanosine and stavudine or tenofovir or abacavir and lamivudine). When virologic failure occurred with second-line therapy or when there were complicated first-line therapy failures, genotypic resistance testing was undertaken.. At the initial visit, all patients underwent a comprehensive physical examination ...
Slide 1 of 11 New Guidelines, Strategies, and Drugs for Initiation of Antiretroviral Therapy 2013 Charles B. Hicks, MD Professor of Medicine Duke University Medical Center Durham, North Carolina From CB Hicks, MD, at Chicago, IL: May 20, 2013, IAS-USA. IAS-USA Improving Practical Skills for Primary Care of HIV-Infected Patients Slide 2 of 11 clinicaloptions.com/hiv Goals of Antiretroviral Therapy  Reduce HIV-associated morbidity and prolong duration and quality of survival  Restore and preserve immunologic function  Maximally and durably suppress HIV-1 RNA - Persistently below level of detection (, 20-75 copies/mL, depending on the assay used) - Isolated "blips" not uncommon in successfully treated patients and not thought to predict virologic failure  Prevent HIV transmission DHHS Guidelines for Antiretroviral Therapy in Adults and Adolescents. March 2012. From CB Hicks, MD, at Chicago, IL: May 20, 2013, IAS-USA. Slide 3 of 11 Improving Practical Skills for Primary Care of ...
Objectives: To assess how developing knowledge surrounding combination antiretroviral treatment for people living with HIV infection since mid-1 996 has altered how drugs are used in Australia. Methods: Time trends in use of antiretroviral treatment were calculated on patients recruited to the Australian HIV Observational Database. For each six month period, patients were on one or more antiretroviral drugs for at least two weeks. Other patients were in the no-treatment group. Patients receiving antiretrovirals for more than two weeks were allocated to the category of treatment (mono, double or triple-plus therapy) they received for the longest period. Results: 1476 patients were recruited by September 2000. Of patients currently receiving antiretroviral therapy, 32 per cent took three or more antiretrovirals including an HIV protease inhibitor (PI) and 27 per cent took triple-plus therapy including a nonnucleoside reverse transcriptase inhibitor (NNRTI). The proportion of patients receiving ...
The National Institutes of Health (NIH) has launched a large international trial called IMPAACT 2010 or VESTED to evaluate three antiretroviral treatment regimens in HIV-infected pregnant women.. The trial aims to investigate the safety and efficacy of these regimens in the 639 participants who are 14 to 28 weeks into their pregnancies, along with safety for their infants.. It will compare the existing World Health Organisation (WHO) recommended, first-line maternal efavirenz (EFV) / emtricitabine (FTC) / tenofovir disoproxil fumarate (TDF) regimen with two other regimens containing newer antiretroviral drugs dolutegravir (DTG) or tenofovir alafenamide (TAF).. The mothers viral load at delivery will be measured to compare the virologic efficacy of these three regimens. The viral load is the amount of HIV in the blood.. In addition, effectivity rates of the regimens on adverse pregnancy outcomes will be monitored such as preterm delivery and low infant birth weight, maternal and infant adverse ...
A series of neamine-heterocycle conjugates were designed and synthesized. All new compounds displayed more potent inhibitory effect on HIV replication than neamine, among them two compounds displayed stronger anti-HIV activity than neomycin B. The results suggested that it might be a promising approach to modify neamine for the discovery of new anti-HIV agents. (C) 2013 Xiao-Lian Zhang, Xin-Shan Ye. Published by Elsevier B.V. on behalf of Chinese Chemical Society. All rights reserved. ...
During the last three decades, HIV/AIDS has become the threat to the world. Almost 75 million people have been infected, and about 36 million people have died of HIV [1]. The introduction of antiretroviral therapy (ART) changes HIV/AIDS from diseases with a high mortality rate to manageable chronic diseases by decreasing the progression of AIDS and reducing HIV-related illness and deaths. Researches revealed that improved access to ART is helping to drive a decline in HIV-related morbidity and mortality [2-5]. In the USA and Canada, a person in his or her 20s who contracts HIV can now expect to live into the 70s if initiated ART early [6].. The standard therapy consists of two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI) [7]. In 2010, these guidelines were revised and recommended less toxic drugs in first-line therapy by replacing stavudine (d4T) with tenofovir (TDF) [8]. In resource-limited countries, World Health ...
In 2013, WHO published the first consolidated guidelines on the use of antiretroviral (ARV) drugs for HIV treatment and prevention across all age groups and populations. A comprehensive revision of these guidelines based on new scientific evidence and lessons from implementation is being undertaken in 2015.. This early-release guideline makes available two key recommendations that were developed during the revision process in 2015. First, antiretroviral therapy (ART) should be initiated in everyone living with HIV at any CD4 cell count. Second, the use of daily oral pre-exposure prophylaxis (PrEP) is recommended as a prevention choice for people at substantial risk of HIV infection as part of combination prevention approaches. The first of these recommendations is based on evidence from clinical trials and observational studies released since 2013 showing that earlier use of ART results in better clinical outcomes for people living with HIV compared with delayed treatment. The second ...
List of wholesalers , traders for antiretroviral arv drugs, 22 antiretroviral arv drugs manufacturers & antiretroviral arv drugs suppliers from China.
In previously untreated patients, combinations that include efavirenz compare favorably with regimens that include either other nonnucleoside reverse transcriptase inhibitors or components from other antiretroviral classes.. Two parallel randomized, placebo-controlled Phase III studies in antiretroviral-naive adults compared efavirenz with rilpivirine, each in combination with 2 NRTIs (predominantly tenofovir + emtricitabine). By ITT analysis of pooled data from the 2 studies, 82% of efavirenz recipients and 84% of rilpivirine recipients had HIV RNA levels of ,50 copies/mL at 48 weeks; the difference was not statistically significant. In patients with HIV RNA ,100,000 copies/mL, the efavirenz regimen resulted in higher rates of virologic suppression. The mean increase in CD4 count was 176 cells/µL in the efavirenz group (compared with 192 cells/µL in the rilpivirine group).(13) A randomized trial comparing efavirenz with nevirapine, each given with lamivudine + stavudine in initial therapy, ...
Among 100 children on first-line cART followed for a median 49 months, 34% experienced virologic failure. Twenty-three (68%) of the 34 children with viral failure had detectable resistance mutations, of whom 14 (61%) had multi-class resistance. Fourteen (14%) children were switched to second-line regimens and followed for a median of 28 months. Retrospective analysis revealed that virologic failure had occurred a median of 12 months prior to the switch to second-line. During prolonged first-line treatment in the presence of viral failure, additional resistance mutations accumulated, however, only 1 (7%) of 14 children had persistent viremia during second-line treatment ...
Several studies intensively evaluated the effect of antiretroviral therapy initiated during acute HIV infection has on the size of the cellular reservoir. One such study compared the reservoir as measured by HIV DNA as total, integrated and 2-long terminal repeat (LTR) in those treated during acute infection (n=9), chronic infection (n=26) and amongst elite controllers (n=37) (15). It was not surprising that HIV DNA was detectable regardless of how early therapy was initiated and amongst the elite controllers. Nevertheless, they did find that the levels were significantly lower in those treated during acute infection than during chronic. Moreover, the levels in the early treatment group were similar to the elite controller. While early treatment did not eliminate the reservoir, even amongst those with 10 years of follow-up, it is conceivable that the success of any future strategies to target the reservoir may be more successful in those with a smaller reservoir, such as those initiating therapy ...
The median age at first treatment interruption was 10.1 years (IQR: 6.4-13.6) after being on ART for 5.5 years. The median treatment interruption was 9.0 months (IQR: 3.5-22.5). The primary reason for treatment interruption was the patients decision and/or non-compliance (49%), followed by treatment failure (22%), doctors decision (17%) and side-effects (9%). A third had more than one treatment interruption. The second, third and fourth treatment interruptions happened at 13.8, 14.8 and 15.8 years of age, respectively. The children had a relatively good immunological status at the first treatment interruption with a mean CD4 percentage of 27.3% (standard deviation 11%). However, only 27% had a suppressed viral load (, 400 copies/mL).. At the end of treatment interruption the mean CD4 percentage was 19.2% (95% CI: 18.3-20.1%). Two years after restarting ART, it rose to 27.1% (95% CI: 26.2-27.9%), therefore reaching the pre-treatment interruption value, with half the increase in the first six ...