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 ...
HIV-1 infection is associated with B cell dysregulation and dysfunction. In HIV-1-infected patients, we previously reported preservation of intestinal lymphoid structures and dendritic cell maturation pathways after early combination antiretroviral therapy (e-ART), started during the acute phase of the infection, compared with late combination antiretroviral therapy started during the chronic phase. In this study, we investigated whether the timing of combination antiretroviral therapy initiation was associated with the development of the HIV-1-specific humoral response in the gut. The results showed that e-ART was associated with higher frequencies of functional resting memory B cells in the gut. These frequencies correlated strongly with those of follicular Th cells in the gut. Importantly, frequencies of HIV-1 Env gp140-reactive B cells were higher in patients given e-ART, in whom gp140-reactive IgG production by mucosal B cells increased after stimulation. Moreover, IL-21 release by PBMCs stimulated
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. ...
Objectives: To determine HIV-1 RNA in cerebrospinal fluid (CSF) of successfully treated patients and to evaluate if combination antiretroviral treatments with higher central nervous system penetration-effectiveness (CPE) achieve better CSF viral suppression. Methods: Viral loads (VLs) and drug concentrations of lopinavir, atazanavir, and efavirenz were measured in plasma and CSF. The CPE was calculated using 2 different methods. Results: The authors analyzed 87 CSF samples of 60 patients. In 4 CSF samples, HIV-1 RNA was detectable with 43-82 copies per milliliter. Median CPE in patients with detectable CSF VL was significantly lower compared with individuals with undetectable VL: CPE of 1.0 (range, 1.0-1.5) versus 2.3 (range, 1.0-3.5) using the method of 2008 (P = 0.011) and CPE of 6 (range, 6-8) versus 8 (range, 5-12) using the method of 2010 (P = 0.022). The extrapolated CSF trough levels for atazanavir (n = 12) were clearly above the 50% inhibitory concentration (IC50) in only 25% of samples; ...
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, ...
A systematic review and meta-analysis from China finds that transmitted drug resistance (TDR) - when people who have never been on antiretroviral treatment (ART) before are already resistant to first-line ART - was found at 3% of cases overall, with significant regional variation. The analysis also found this type of drug-resistant HIV has been accelerating in China since 2012, mainly due to resistance to a class of ART known as non-nucleoside reverse transcriptase inhibitors (NNRTI).. The review, published in The Lancets E-Clinical Medicine, analysed 170 studies to assess the level, trend and geographical distribution of HIV drug resistance between 2001 and 2017, and the most common genetic mutations that cause it.. Studies included in this analysis, the most comprehensive of its kind to date, relate to 21,450 people living with HIV who had not been on antiretroviral treatment (ART) before (otherwise known as treatment or ART-naïve), and 30,475 people who had previously been on ...
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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Atazanavir sulfate is a drug used in the treatment of human immunodeficiency virus (HIV) infection, including all stages of HIV infection and acquired
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TY - JOUR. T1 - Antiretroviral treatment of adult HIV infection. T2 - 2008 Recommendations of the international AIDS society-USA panel. AU - Hammer, Scott M.. AU - Eron, Joseph J.. AU - Reiss, Peter. AU - Schooley, Robert T.. AU - Thompson, Melanie A.. AU - Walmsley, Sharon. AU - Cahn, Pedro. AU - Fischl, Margaret A.. AU - Gatell, Jose M.. AU - Hirsch, Martin S.. AU - Jacobsen, Donna M.. AU - Montaner, Julio S.G.. AU - Richman, Douglas D.. AU - Yeni, Patrick G.. AU - Volberding, Paul A.. PY - 2008/8/6. Y1 - 2008/8/6. N2 - Context: The availability of new antiretroviral drugs and formulations, including drugs in new classes, and recent data on treatment choices for antiretroviral-naive and -experienced patients warrant an update of the International AIDS Society-USA guidelines for the use of antiretroviral therapy in adult human immunodeficiency virus (HIV) infection. Objectives: To summarize new data in the field and to provide current recommendations for the antiretroviral management and ...
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 ARV Therapies and Therapeutic Strategies program is a comprehensive, independent review of the 25th Conference on Retroviruses and Opportunistic Infections (CROI 2018). This program consists of three components: (1) CME Internet Symposium: CROI 2018 Expert Review: a 1.5 hour Internet symposium that features an overview and discussion of key presentations and posters, selected by the expert faculty discussants; (2) Rapid-Fire Review of CROI 2018: a podcast that provides a brief, audio summary of the most essential data presented at the conference; and (3) From Conference to Clinic: Reviewing and Applying Data From CROI 2018: case-based dinner meetings during which the key data are reviewed, discussed and applied to patient care ...
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.
© 2020 The Author(s) Background: Early combination antiretroviral therapy (cART) reduces the size of the viral reservoir in paediatric and adult HIV infection. Very early-treated children may have higher cure/remission potential. Methods: In an observational study of 151 in utero (IU)-infected infants in KwaZulu-Natal, South Africa, whose treatment adhered strictly to national guidelines, 76 infants diagnosed via point-of-care (PoC) testing initiated cART at a median of 26 h (IQR 18-38) and 75 infants diagnosed via standard-of-care (SoC) laboratory-based testing initiated cART at 10 days (IQR 8-13). We analysed mortality, time to suppression of viraemia, and maintenance of aviraemia over the first 2 years of life. Findings: Baseline plasma viral loads were low (median 8000 copies per mL), with 12% of infants having undetectable viraemia pre-cART initiation. However, barely one-third (37%) of children achieved suppression of viraemia by 6 months that was maintained to |12 months. 24% had died or were
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 ...
On December 31, 2012, FDA approved Fulyzaq (crofelemer) to relieve symptoms of diarrhea in HIV/AIDS patients taking combination antiretroviral therapy. ...
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. ...
ABSTRACT: BACKGROUND: Structured interruptions of antiretroviral therapy of HIV-1 infected individuals are currently being tested in clinical trials to study the effect interruptions have on the immune responses and control of virus replication. OBJECTIVE: To investigate the potential risks and benefits of interrupted therapy using standard population dynamical models of HIV replication kinetics. METHODS: Standard population dynamical models were used to study the effect of structured therapy interruptions on the immune effector cells, the latent cell compartment and the emergence of drug resistance. CONCLUSIONS: The models suggest that structured therapy interruption only leads to transient or sustained virus control if the immune effector cells increase during therapy. This increase must more than counterbalance the increase in susceptible target cells induced by therapy. The risk of inducing drug resistance by therapy interruptions or the risk of repopulating the pool of latent cells during ...
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 ...
BACKGROUND: Etravirine (ETR), a non-nucleoside reverse transcriptase inhibitor (NNRTI) available in France since 2006, is indicated for antiretroviral-experienced HIV-infected adults, in combination with a ritonavir-boosted protease inhibitor (PI). To assess its clinical impact in routine care, we compared hospitalization rates according to ETR + PI prescription or not, among heavily treated HIV-1 infected individuals on failing regimens between 2005 and 2011. METHODS: From the French Hospital Database on HIV (ANRS CO4), we selected heavily treated individuals (prior exposure to at least 2 nucleoside reverse transcriptase inhibitor (NRTI), 2PI and 1 NNRTI) with viral load (VL) | 50 copies/mL who started a new antiretroviral (ARV) regimen between 2005 and 2011. Using an intention-to-continue-treatment approach, hospitalization rates were calculated for the individuals who received ETR + PI, during the months after initiating ETR + PI (ETR + PI) or for the individuals who received ETR + PI, in the
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 ...
We investigated the evolution of HIV reverse transcriptase (RT)- and protease-associated antiretroviral (ARV) drug resistance mutations during the time taken to perform genotypic drug resistance testing. Thirty treatment-experienced patients who were adherent to therapy and who underwent genotypic drug resistance testing provided blood samples at randomization and when reviewing the test results (baseline). Patients remained on their existing therapy between randomization and baseline. The predominant HIV strains in 10 patients (33%) either lost and/or gained primary RT inhibitor (RTI) or protease inhibitor (PI) associated resistance mutations during the testing period. Of the 9 patients with RT mutations, 2 lost, 5 gained, and 2 both lost and gained RTI resistance mutations. One patient gained a significant PI-associated resistance mutation on an existing PI-resistant background. The evolution that occurred in the RT may have altered the effectiveness of subsequent ARV therapy in some patients ...
TY - JOUR. T1 - Efavirenz liquid formulation in human immunodeficiency virus-infected children. AU - Starr, Stuart E.. AU - Fletcher, Courtney V.. AU - Spector, Stephen A.. AU - Brundage, Richard C.. AU - Yong, Florence H.. AU - Douglas, Steven D.. AU - Flynn, Patrizia M.. AU - Kline, Mark W.. PY - 2002/7/23. Y1 - 2002/7/23. N2 - Background. This study determined the safety, pharmacokinetics, antiviral activity and immunologic effects of efavirenz liquid formulation, nelfinavir and nucleoside reverse transcriptase inhibitors (NRTIs) in HIV-infected children, 3 to 9 years of age. Methods. Plasma HIV-1 RNA and lymphocyte subsets were measured at various intervals after initiation of therapy. Pharmacokinetic studies were performed at Week 2, and doses of efavirenz and nelfinavir were adjusted if area under the curve values fell outside specified target ranges. Results. This combination of antiretrovirals was well-tolerated. Pharmacokinetic values were similar to those observed in a previous study ...
Title: Metabolic and Cardiovascular Complications of Highly Active Antiretroviral Therapy for HIV Infection. VOLUME: 4 ISSUE: 1. Author(s):Giuseppe Barbaro. Affiliation:Viale Anicio Gallo 63,00174 Rome, Italy.. Keywords:Human immunodeficiency virus, highly active antiretroviral therapy, nucleoside reverse transcriptase inhibitors, protease inhibitors, metabolic syndome, cardiovascular disease. Abstract: Highly active antiretroviral therapy (HAART) regimens, especially those including protease inhibitors have been shown to cause, in a high proportion of HIV-infected patients, a metabolic syndrome (lipodystrophy/lipoatrophy, dyslipidemia, type 2 diabetes mellitus, insulin resistance) that may be associated with an increased risk of cardiovascular disease. A careful stratification of the cardiovascular risk of HIVinfected patients under HAART is needed according to the most recent clinical guidelines. ...
2015 Elsevier Ltd. Background Tenofovir disoproxil fumarate can cause renal and bone toxic effects related to high plasma tenofovir concentrations. Tenofovir alafenamide is a novel tenofovir prodrug with a 90% reduction in plasma tenofovir concentrations. Tenofovir alafenamide-containing regimens can have improved renal and bone safety compared with tenofovir disoproxil fumarate-containing regimens. Methods In these two controlled, double-blind phase 3 studies, we recruited treatment-naive HIV-infected patients with an estimated creatinine clearance of 50 mL per min or higher from 178 outpatient centres in 16 countries. Patients were randomly assigned (1:1) to receive once-daily oral tablets containing 150 mg elvitegravir, 150 mg cobicistat, 200 mg emtricitabine, and 10 mg tenofovir alafenamide (E/C/F/tenofovir alafenamide) or 300 mg tenofovir disoproxil fumarate (E/C/F/tenofovir disoproxil fumarate) with matching placebo. Randomisation was done by a computer-generated allocation sequence (block ...
Semantic Scholar extracted view of Adenovirus viremia in human immunodeficiency virus-infected children. by Ronald M. Ferdman et al.
Results: A total 307 human immunodeficiency virus positive patients, 153 highly active antiretroviral therapy na ve (who didnt take highly active antiretroviral therapy) and 154 on highly active antiretroviral therapy were enrolled in the study. The mean ( SD) age of the participants was 34.69 ( 8.86) years and about 61% were females. The prevalence of renal impairment in highly active antiretroviral therapy na ve and on highly active antiretroviral therapy individuals was 30.1% and 12.9% respectively. Proteinuria was found in 17.9 % of the participant. Low CD4 count (Adjusted odds ratio= 24.11; (95% CI 11.06, 52.56) and being highly active antiretroviral therapy na ve (Adjusted odds ratio = 6.58; 95% CI 2.99, 14.47) showed significant association with the prevalence of renal impairment ...
TY - JOUR. T1 - Effect of highly active antiretroviral therapy on time to acquired immunodeficiency syndrome or death using marginal structural models. AU - Cole, Stephen R.. AU - Hernán, Miguel A.. AU - Robins, James M.. AU - Anastos, Kathryn. AU - Chmiel, Joan. AU - Detels, Roger. AU - Ervin, Carolyn. AU - Feldman, Joseph. AU - Greenblatt, Ruth. AU - Kingsley, Lawrence. AU - Lai, Shenghan. AU - Young, Mary. AU - Cohen, Mardge. AU - Muñoz, Alvaro. N1 - Funding Information: The Multicenter AIDS Cohort Study is funded by the National Institute of Allergy and Infectious Diseases, with additional supplemental funding from the National Cancer Institute (grants UO1-AI-35042, 5-MO1-RR-00722 (General Clinical Research Center), UO1-AI-35043, UO1-AI-37984, UO1-AI-35039, UO1-AI-35040, UO1-AI-37613, and UO1-AI-35041). The Womens Interagency HIV Study is funded by the National Institute of Allergy and Infectious Diseases, with supplemental funding from the National Cancer Institute, the National ...
Emtricitabine/tenofovir disoproxil fumarate drug information: uses, indications, side effects, dosage. Compare prices for generic emtricitabine/tenofovir disoproxil fumarate substitutes: Emtricitabine and Tenofovir Tablets, Tavin- EM, Tenof- EM
OBJECTIVE: To examine the effect of different antiretroviral treatment regimens on viral load, CD4 lymphocyte counts, and rates of progression to clinical acquired immunodeficiency syndrome events among treatment-naive human immunodeficiency virus (HIV)-infected patients enrolled in a large community cohort study. METHODS: Based in 7 outpatient clinics, the Swiss HIV Cohort Study is a cohort with national coverage. Virological, immunologic, and clinical results of 755 treatment-naive patients (median age, 36 years; 28.2% female) who initiated antiretroviral therapy between July 1, 1995, and June 30, 1997, were analyzed. Patients started undergoing monotherapy with 1 reverse transcriptase inhibitor (RTI), combination therapy with at least 2 RTIs, or highly active antiretroviral therapy (HAART) with RTIs and protease inhibitors. RESULTS: Antiretroviral treatment led to a mean reduction of viremia of 1.8 log10 copies per milliliter with HAART, 1.2 log10 copies per milliliter with RTI comb
TY - JOUR. T1 - Immune Complexes in Pediatric Human Immunodeficiency Virus Infection. AU - Ellaurie, Maadhava. AU - Calvelli, Theresa. AU - Rubinstein, Arye. PY - 1990/11. Y1 - 1990/11. N2 - Circulating immune complexes (CIC) were analyzed in a cohort of 30 children infected with the human immunodeficiency virus. Elevated CIC were detected by the C1 q assay in 70% (21/30) of all patients and by the Raji cell assay in 93% (28/30) of all patients. While only less than one third of patients with elevated CIC had free serum antibodies to Epstein-Barr virus, 80% (16/20) of them had detectable antibodies to Epstein-Barr virus associated with CIC. Enriched CIC in human immunodeficiency virus-infected children contained low levels of complement. These findings document that, as an expression of the humoral immunodeficiency, CIC in human immunodeficiency virus-infected children are deficient in complement and can thus be underestimated if complement-precipitating methods are used for their ...
TY - JOUR. T1 - Cervicovaginal HIV-1 shedding in women taking antiretroviral therapy in Burkina Faso. T2 - a longitudinal study. AU - Low, Andrea J. AU - Konate, Issouf. AU - Nagot, Nicolas. AU - Weiss, Helen A. AU - Kania, Dramane. AU - Vickerman, Peter. AU - Segondy, Michel. AU - Mabey, David. AU - Pillay, Deenan. AU - Meda, Nicolas. AU - van de Perre, Philippe. AU - Mayaud, Philippe. AU - Yerelon Study Group. PY - 2014/2/1. Y1 - 2014/2/1. N2 - BACKGROUND: Antiretroviral therapy (ART) reduces transmission of HIV-1. However, genital HIV-1 can be detected in patients on ART. We analyzed factors associated with genital HIV-1 shedding among high-risk women on ART in Burkina Faso.METHODS: Plasma viral load (PVL) and enriched cervicovaginal lavage HIV-1 RNA were measured every 3-6 months for up to 8 years. Random-effects logistic and linear regression models were used to analyze associations of frequency and quantity of genital HIV-1 RNA with behavioral and biological factors, adjusting for ...
Background: New WHO guidelines recommend initiation of antiretroviral therapy for HIV-positive adults with CD4 counts of 500 cells per μL or less, a higher threshold than was previously recommended. Country decision makers have to decide whether to further expand eligibility for antiretroviral therapy accordingly. We aimed to assess the potential health benefits, costs, and cost-effectiveness of various eligibility criteria for adult antiretroviral therapy and expanded treatment coverage.. Methods: We used several independent mathematical models in four settings-South Africa (generalised epidemic, moderate antiretroviral therapy coverage), Zambia (generalised epidemic, high antiretroviral therapy coverage), India (concentrated epidemic, moderate antiretroviral therapy coverage), and Vietnam (concentrated epidemic, low antiretroviral therapy coverage)-to assess the potential health benefits, costs, and cost-effectiveness of various eligibility criteria for adult antiretroviral therapy under ...
To describe the early response to World Health Organization (WHO)-recommended nonnucleoside reverse transcriptase inhibitor (NNRTI)-based first-line highly active antiretroviral therapy (HAART) in HIV-1-infected Kenyan children unexposed to nevirapine. Observational prospective cohort. HIV-1 RNA level, CD4 lymphocyte count, weight for age z score, and height for age z score were measured before the initiation of HAART and every 3 to 6 months thereafter. Children received no nutritional supplements. Sixty-seven HIV-1-infected children were followed for a median of 9 months between August 2004 and November 2005. Forty-seven (70%) used zidovudine, lamivudine (3TC), and an NNRTI (nevirapine or efavirenz), whereas 25% used stavudine (d4T), 3TC, and an NNRTI. Nevirapine was used as the NNRTI by 46 (69%) children, and individual antiretroviral drug formulations were used by 63 (94%), with only 4 (6%) using a fixed-dose combination of d4T, 3TC, and nevirapine (Triomune; Cipla, Mumbai, India). In 52 ...
Objective:To evaluate HIV-1 transmission trends and the impact of highly active antiretroviral therapy (HAART) on newly diagnosed HIV infections in Geneva, Switzerland.Design:Retrospective molecular epidemiology analysis of all newly HIV-diagnosed individuals between 2008 and 2010.Methods:Phylogenet
TY - JOUR. T1 - Antidepressant treatment and adherence to combination antiretroviral therapy among patients with AIDS and diagnosed depression. AU - Walkup, James. AU - Wei, Wenhui. AU - Sambamoorthi, Usha. AU - Crystal, Stephen. N1 - Funding Information: Acknowledgements Support for this research was provided by funding from grants: MH 58984-03, MH 60831, MH076206-01 and HS 016097.. PY - 2008/3. Y1 - 2008/3. N2 - Background: The prevalence of depression is elevated among HIV-infected individuals and there is evidence that depression exerts a negative impact on HIV medication adherence. Methods: Merged HIV/AIDS surveillance data and Medicaid claims data from January 1996 to December 1998 were used to identify AIDS-infected patients with diagnosed depression, and filled prescriptions were used to identify their antidepressant use, and highly active antiretroviral therapy (HAART). Chi-square tests and robust logistic regressions were used to examine antidepressant use after HAART initiation, and a ...
TY - JOUR. T1 - Improvement in lipoatrophy associated with highly active antiretroviral therapy in human immunodeficiency virus-infected patients switched from stavudine to abacavir or zidovudine. T2 - The results of the TARHEEL study. AU - Bartlett, John. PY - 2004/1/1. Y1 - 2004/1/1. UR - http://www.scopus.com/inward/record.url?scp=85026137152&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=85026137152&partnerID=8YFLogxK. U2 - 10.1097/01.idc.0000130889.35482.ee. DO - 10.1097/01.idc.0000130889.35482.ee. M3 - Article. AN - SCOPUS:85026137152. VL - 12. JO - Infectious Diseases in Clinical Practice. JF - Infectious Diseases in Clinical Practice. SN - 1056-9103. IS - 4. ER - ...
Fingerprint Dive into the research topics of Compromised immunologic recovery in treatment-experienced patients with HIV infection receiving both tenofovir disoproxil fumarate and didanosine in the TORO studies. Together they form a unique fingerprint. ...
Objective: Some HIV patients treated with highly active antiretroviral therapy (HAART) do not resolve their plasma viraemia or HIV RNA can reappear after a period of virological control. We investigate whether polymorphisms in cytokine genes affect the control of plasma HIV RNA over 5 years on HAART. Design: The study utilized adult HIV-infected patients in Western Australia. Plasma HIV-RNA levels were assessed from commencement of HAART in patients who had a CD4 T-cell count less than 100 cells/μl before HAART and achieved immune reconstitution assessed by CD4 T-cell counts. Results: Control of plasma viraemia could be predicted from carriage of allele 2 at position -889 in the IL1A gene (IL1A-889*2). This was significant when assessed by the proportion of patients with a plasma HIV-RNA level of 400 copies/ml or less (P = 0.002). At 48 months post-HAART, proportions were approximately 0.76, 0.51 and 0.32 for IL1A (1,1), (1,2) and (2,2) patients, respectively. The outcome was independent of the ...
PubMed journal article: CD4+ cell count, viral load, and highly active antiretroviral therapy use are independent predictors of body composition alterations in HIV-infected adults: a longitudinal study. Download Prime PubMed App to iPhone, iPad, or Android
Primary HIV-associated thrombocytopenia (PHAT) typically improves with highly active antiretroviral therapy (HAART); however, cases continue to occur. Data comparing the epidemiology of PHAT between the pre-HAART and HAART eras are limited. We retrospectively examined the incidence of PHAT over 28 years in the US Military HIV Natural History Study (NHS) from 1986 to 2013. Subjects had a nadir platelet count |100 × 109/l with no other identifiable cause. Time periods were categorized as pre-HAART (1986-1995), early HAART (1996-2001), and later HAART (2002-2013). Incidence, demographic data, and CD4 count were compared across the three eras. A generalized estimating equations model was used to assess any association of platelet count and HIV viral load in cases diagnosed during the HAART eras. 218 participants met the case definition. 86.2 % of cases occurred prior to 2002. The incidence of PHAT per 1000 person-years of follow-up was 16.3, 4.6, and 1.9 during pre-HAART, early HAART and later HAART eras
1. PerelsonAS, EssungerP, CaoY, VesanenM, HurleyA, et al. (1997) Decay characteristics of HIV-1-infected compartments during combination therapy. Nature 387: 188-191.. 2. GulickRM, MellorsJW, HavlirD, EronJJ, GonzalezC, et al. (1997) Treatment with indinavir, zidovudine, and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy. The New England journal of medicine 337: 734-739.. 3. WalenskyRP, PaltielAD, LosinaE, MercincavageLM, SchackmanBR, et al. (2006) The survival benefits of AIDS treatment in the United States. The Journal of infectious diseases 194: 11-19.. 4. HammerSM, SquiresKE, HughesMD, GrimesJM, DemeterLM, et al. (1997) A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less. AIDS Clinical Trials Group 320 Study Team. The New England journal of medicine 337: 725-733.. 5. RichmanDD, MargolisDM, DelaneyM, GreeneWC, HazudaD, et ...
We analyzed the effect of age on highly active antiretroviral therapy efficacy and tolerance in 639 patients with human immunodeficiency virus (HIV) infection (99 of whom were aged ,50 years, and 540 of whom were aged ,50 years). Late testing, which was more frequent in the older age group, was the only independent factor associated with immunologic and clinical evolution of infection. Age ,50 years was associated with earlier treatment discontinuation.. ...
We next isolated highly purified populations of resting CD4+ T cells from the peripheral blood of these donors. After depletion of monocytes by adherence, negative selection with monoclonal antibodies and magnetic beads was used to remove CD8+ T cells, B cells, monocytes, and natural killer cells. In addition, activated CD4+ T cells, which represented an average of 10% of the CD4+ T cell populations in these individuals (Table 1), were removed by bead depletion with antibodies to CD25, CD69, and human lymphocyte antigen (HLA)-DR. Additional purification was achieved by flow cytometric sorting of small lymphocytes expressing CD4 but not HLA-DR, which is expressed on all activated T cells. This multistep purification gave populations of resting CD4+ HLA-DR− T cells that were, on average, 97% pure (Table 1). Most importantly, the sorted populations were typically contaminated with ,1% activated CD4+ T cells.. Specialized PCR approaches have shown that a low frequency of resting CD4+ T cells from ...
A pilot longitudinal study was conducted for 3 months on HIV positive and AIDS patients on antiretroviral therapy, at a day care clinic at the Yaoundé Central Hospital, Cameroon, between April and July 2008. A total of 223 HIV patients were recruited following initiation and each patient benefited from pretherapeutic tests. Social-demographic, clinical and biological data were recorded for each subject and finally analyzed using standard statistical procedures. Out of the 223 subjects on highly active antiretroviral therapy (HAART) in the study, 153 were females (68. 6%) and 70 were males (31. 6%). The age group that was most represented was 30 - 39 (37.7%). The mean age of patients was 39.34 ± 11.31 years. At initiation the highest administered antiretroviral (ARV) regimen was Zidulam N (34.10%). For hepatotoxicity evaluation, with aspartate aminotransferase (ASAT) study, 5.8% of patients showed degree 1 and 1.3% of patients had degree 2 changes. In alanine amino transferase