TY - JOUR. T1 - The effects of highly active antiretroviral therapy on albuminuria in HIV-infected persons. T2 - Results from a randomized trial. AU - Gupta, Samir K.. AU - Parker, Robert A.. AU - Robbins, Gregory K.. AU - Dubé, Michael P.. PY - 2005/10/1. Y1 - 2005/10/1. N2 - Background. Human immunodeficiency virus (HIV)-infected patients receiving highly active antiretroviral therapy (HAART) regimens, especially those containing protease inhibitors (PIs), are at increased risk for cardiovascular events. Albuminuria is a known independent predictor for the development of cardiovascular disease and may potentially increase in patients receiving PIs. Alternatively, albuminuria may improve with HAART as a result of treating renal parenchymal HIV infection. Longitudinal studies have not been performed previously addressing the effects of HAART on albuminuria. Methods. We evaluated the effects of HAART on albumin to creatinine ratios (ACRs) during the initial 64 weeks of therapy in 68 previously ...
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. ...
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 ...
To identify factors associated with successful treatment of KS with antiretroviral therapy and to determine if highly active antiretroviral therapy improves survival and quality of life for persons with AIDS-KS in Zimbabwe.. A secondary objective is to investigate the durability of HIV-1 suppression by the combination of ABC/3TC/ZDV in persons infected with HIV-1 subtype C and to evaluate the timing and characteristics of mutations in HIV-1 reverse transcriptase in subjects who fail to achieve, or to maintain suppression of HIV-1 replication during treatment with ABC/3TC/ZDV.. An important objective is to assess adherence to a simplified antiretroviral regimen in a resource-limited setting.. The study will evaluate the clinical, immunological, and virological effects of a switch from a twice-daily all-nucleoside reverse transcriptase inhibitor (NRTI) antiretroviral regimen to a once-daily regimen of 2 NRTIs plus a ritonavir-boosted protease inhibitor in persons with AIDS-KS and good virologic ...
To identify factors associated with successful treatment of KS with antiretroviral therapy and to determine if highly active antiretroviral therapy improves survival and quality of life for persons with AIDS-KS in Zimbabwe.. A secondary objective is to investigate the durability of HIV-1 suppression by the combination of ABC/3TC/ZDV in persons infected with HIV-1 subtype C and to evaluate the timing and characteristics of mutations in HIV-1 reverse transcriptase in subjects who fail to achieve, or to maintain suppression of HIV-1 replication during treatment with ABC/3TC/ZDV.. An important objective is to assess adherence to a simplified antiretroviral regimen in a resource-limited setting.. The study will evaluate the clinical, immunological, and virological effects of a switch from a twice-daily all-nucleoside reverse transcriptase inhibitor (NRTI) antiretroviral regimen to a once-daily regimen of 2 NRTIs plus a ritonavir-boosted protease inhibitor in persons with AIDS-KS and good virologic ...
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
Objective: To determine whether opportunistic oral infections associated to HIV infection (OOI-HIV) are found in HIV+/AIDS patients with immune reconstitution related to highly active antiretroviral therapy (HAART). Methods. From among 1100 HIV+/AIDS patients (Service of Internal Medicine, Carlos Haya Hospital, Malaga, Spain) subjected to review of the oral cavity between January 1996 and May 2007, we identified those examined in 1996 and which were again examined between 1997 and 2007, and were moreover receiving HAART. The following data were collected: age, gender, form of contagion, antiretroviral therapy at the time of review, number of CD4+ lymphocytes/ml, and viral load (from 1997 onwards). We identified those subjects with an increase in CD4+ lymphocytes/ml associated to HAART, and classified them as subjects with quantitative evidence of immune reconstitution (QEIR). Among these individuals with QEIR we moreover identified those with undetectable viral loads (QEIR+VL), and ...
ABSTRACT Objective: Studies have shown that HIV-infected injection drug users (IDUs) are less likely to receive antiretroviral therapy than non-drug users. We assess factors associated with initiating highly active antiretroviral therapy (HAART) in HIV-infected IDUs. Methods: A cohort study of IDUs carried out between 1 January 1996 and 30 June 1999 at a community-based study clinic affiliated to the Johns Hopkins University, Baltimore, Maryland. The participants were a total of 528 HIV-infected IDUs eligible for HAART based on CD4+ cell count. The main outcome measure was the time from treatment eligibility to first self-reported HAART use, as defined by the International AIDS Society USA panel (IAS USA) guidelines. Results: By 30 June 1999, 58.5% of participants had initiated HAART, most of whom switched from mono- or dual-combination therapy to a HAART regimen. Nearly one-third of treatment-eligible IDUs never received antiretroviral therapy. Cox proportional hazards regression showed that ...
Highly active antiretroviral therapy (HAART) can suppress HIV-1 replication and normalize the chronic immune activation associated with infection, yet restoration of na?ve Compact disc4+ Capital t cell populations is definitely sluggish and usually incomplete for factors that possess yet to end up being determined. degree of reduction of the FRC network and collagen deposit anticipate the degree of repair of the na?velizabeth T cell population after 6 GSK1838705A month of HAART, and that repair of FRC systems correlates with the stage of disease at which the therapy is initiated. Because repair of the FRC network and reconstitution of na?velizabeth T cell populations are just optimal when therapy is initiated in the early/extreme stage of infection, our results strongly suggest that HAART should end up being initiated while soon while feasible. Furthermore, our results also stage to the Rabbit Polyclonal to ANKRD1 potential make use of of adjunctive anti-fibrotic therapies to avert or moderate ...
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 ...
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.. ...
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
TY - JOUR. T1 - Trend of CD4+ cell counts at diagnosis and initiation of highly active antiretroviral therapy (HAART). T2 - Korea HIV/AIDS cohort study, 1992-2015. AU - Korea HIV/AIDS Cohort Study. AU - Kim, Min Jung. AU - Chang, Hyun Ha. AU - Kim, Sang Il. AU - Kim, Youn Jeong. AU - Park, Dae Won. AU - Kang, Chun. AU - Kee, Mee Kyung. AU - Choi, Ju yeon. AU - Kim, Soo Min. AU - Choi, Bo Youl. AU - Kim, Woo Joo. AU - Kim, June Myung. AU - Choi, JunYong. AU - Choi, Young Hwa. AU - Lee, Jin Soo. AU - Kim, Shin Woo. AU - Kim, Min Ja. AU - Sohn, Jang Wook. AU - Yoon, Young Kyung. AU - Woo, Jun Hee. AU - Kim, Youn Jeong. AU - Choi, Won Suk. AU - Wie, Seong Heon. AU - Hur, Ji An. AU - Kim, Min Jung. AU - Lee, Sang Ah. AU - Song, Joon Young. AU - Eom, Joong Shik. AU - Lee, Jin Seo. AU - Park, So Yeon. AU - Jeong, Hye Won. AU - Lee, Jin Soo. AU - Baek, Ji Hyeon. AU - Choi, Hee Jung. AU - Choi, Jun Yong. AU - Ku, Nam Su. AU - Kim, Hyo Youl. AU - Choi, Young Hwa. AU - Lee, Eun Jung. AU - Kim, Tae ...
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 ...
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 - ...
Background Men infected with HIV and receiving highly active antiretroviral therapy are at higher risk of metabolic and cardiovascular abnormalities as well as accelerated renal function decline and chronic kidney disease (CKD). Glomerular hyperfiltration, defined as elevated glomerular filtration rate (GFR) to pathologically high levels, is associated with diabetes and hypertension and is a treatable risk factor for CKD. The epidemiology of hyperfiltration has not been described in an HIV population. The purposes of this dissertation is to a) describe the prevalence of elevated GFR using directly measured iohexol GFR, a gold standard; b) describe the incidence of hyperfiltration using the serum creatinine-based CKD-EPI estimated GFR equation, a clinical standard; and c) investigate the effect of hyperfiltration on accelerated GFR decline in the Multicenter AIDS Cohort Study. Methods Data consisted of a nested cross-sectional study within the MACS comprising 241 HIV-uninfected and 367 ...
OBJECTIVES: Current British HIV Association (BHIVA) guidelines recommend that all patients with a CD4 count ,350 cells/μL are offered highly active antiretroviral therapy (HAART). We identified risk factors for delayed initiation of HAART following a CD4 count ,350 cells/μL.METHODS: All adults under follow-up in 2008 who had a first confirmed CD4 count ,350 cells/μL from 2004 to 2008, who had not initiated treatment and who had ,6 months of follow-up were included in the study. Characteristics at the time of the low CD4 cell count and over follow-up were compared to identify factors associated with delayed HAART uptake. Analyses used proportional hazards regression with fixed (sex/risk group, age, ethnicity, AIDS, baseline CD4 cell count and calendar year) and time-updated (frequency of CD4 cell count measurement, proportion of CD4 counts ,350 cells/μL, latest CD4 cell count, CD4 percentage and viral load) covariates.RESULTS: Of 4871 patients with a confirmed low CD4 cell count, 436 (8.9%) ...
TY - JOUR. T1 - HIV infection and cancer in the era of highly active antiretroviral therapy (Review). AU - Barbaro, Giuseppe. AU - Barbarini, Giorgio. PY - 2007/5. Y1 - 2007/5. N2 - The majority of cancers affecting HIV-infected subjects are those established as acquired immunodeficiency syndrome (AIDS)-defining: Kaposis sarcoma (KS), non-Hodgkins lymphoma (NHL), and invasive cervical cancer (ICC). However, other types of cancer, such as Hodgkins disease (HD), anal cancer, lung cancer and testicular germ cell tumors appear to be more common among HIV-infected subjects compared to the general population. While not classified as AIDS-defining, these malignancies have been referred to as AIDS-associated malignancies. The mechanisms by which depressed immunity could increase the risk for cancer are unclear, except for in KS and most subtypes of NHL, where it is strictly associated with a low CD4 count. Although it remains unclear whether HIV-1 acts directly as an oncogenic agent, it may ...
To examine the prognosis of patients who present with very advanced HIV-induced immunodeficiency, and their response to highly active antiretroviral therapy (HAART), a series of 101 treatment naïve patients from the Serbian cohort of HIV infected patients, who presented with a CD4 count of ≤ 50/µL before commencing HAART, was retrospectively analyzed and factors influencing response to HAART and survival investigated. After a mean of three years (range 1-9) of treatment with PI-based and/or NNRTI-based regimens, a favorable response was achieved in 54.5% of the patients, treatment failure occurred in 13.9%, while 31.7% had a dissociative immunological/virological response. The overall estimated survival was eight years. Achievement of undetectable viremia during treatment appeared life saving (OR = 42.5, 95% CI 7.1 - 251.9, P = 0.000, as was a rise in CD4 cell count to over 200/μL (OR = 6.4, 95% CI 1.2- 31.8, P = 0.023). However, undetectable viremia was the single predictor of longer ...
BACKGROUND: Sub-optimal adherence to highly active antiretroviral therapy (HAART) among injection drug users (IDUs) is a significant concern. As such, there is an urgent need to identify psychosocial determinants of adherence that can be incorporated into interventions designed to promote optimal adherence. OBJECTIVE: To identify psychosocial determinants of adherence to HAART, as well as self-reported reasons for missing doses of HAART among HIV-infected IDUs.
Background. Because antiretrovirals are becoming increasingly available in developing countries, we reviewed the findings of studies that have documented highly active antiretroviral therapy (HAART) use in Africa to identify lessons learned. With the World Health Organization (WHO) guidelines used as a frame of reference, we assessed the feasibility of implementing such programs in Africa. Moreover, clinical and laboratory outcomes were compiled to determine the effectiveness of HAART programs.. Methods. We searched academic databases and recent conference abstracts for studies, and we included all studies that documented patients receiving HAART in Africa. In particular, we examined studies for such program features as type of regimen and frequency of monitoring, in addition to evaluations of patient outcomes.. Results. Twenty-eight articles and abstracts involving studies from 14 African countries were reviewed. Overall, 6052 patients (96.4%) were receiving HAART, mainly consisting of 2 ...
The introduction of highly active antiretroviral therapy (HAART) has had a dramatic impact on the morbidity and mortality of individuals living with human immunodeficiency virus (HIV). In addition to contributing to declines in the incidence of several opportunistic infections, HAART is affecting the incidences of several acquired immunodeficiency syndrome (AIDS)-defining malignancies. 1
The intermediate to high grade B-cell non-Hodgkin lymphomas are now one of three malignant AIDS defining conditions. The others being Kaposis sarcoma and cervical carcinoma. While co-infection with oncogenic agents including the human herpes 8 or Epstein-Barr virus offer targets in preventive treatment strategies for these AIDS defining lymphomas (ADL), administration of highly active antiretroviral therapy leading to immune reconstitution permits use of standard or even high-dose cytotoxic drug regimens with curative intent. It is not certain whether this should be done concomitantly or sequentially. Additional benefit may derive from infusional or high-dose chemotherapy regimens depending on the histological subtype while use of monoclonal antibodies such as rituximab or immunohaematopoietic stem cell transplantation needs to be further evaluated within controlled studies. Socio-economic considerations have an impact especially in resource limited settings while availability of tools for ...
The contents of this dissertation contain three experiments aimed at determining the intracellular mechanisms involved in the induction of highly active antiretroviral therapy (HAART)-induced skeletal muscle insulin resistance and potential therapeutic approaches to increase insulin sensitivity. ❧ The data from the first study indicate that the insulin sensitizing agent, metformin, activates AMPKα₁ preferentially over AMPKα₂ in skeletal muscle cells. Additionally, the metformin treated groups had decreased rates of FA uptake and oxidation when compared to control cells. Interestingly, in the metformin treated groups, the FA transport protein CD36 was similarly decreased with FA uptake, however, a key regulator of FA oxidation, ACC, did not have reduced phosphorylation with metformin treatment. Furthermore, metformin treatment increased SIRT1 activity and decreased PGC-1α acetylation indicating cross-talk between AMPK and SIRT1. Additional data using genetically modified cells with ...
The contents of this dissertation contain three experiments aimed at determining the intracellular mechanisms involved in the induction of highly active antiretroviral therapy (HAART)-induced skeletal muscle insulin resistance and potential therapeutic approaches to increase insulin sensitivity. ❧ The data from the first study indicate that the insulin sensitizing agent, metformin, activates AMPKα₁ preferentially over AMPKα₂ in skeletal muscle cells. Additionally, the metformin treated groups had decreased rates of FA uptake and oxidation when compared to control cells. Interestingly, in the metformin treated groups, the FA transport protein CD36 was similarly decreased with FA uptake, however, a key regulator of FA oxidation, ACC, did not have reduced phosphorylation with metformin treatment. Furthermore, metformin treatment increased SIRT1 activity and decreased PGC-1α acetylation indicating cross-talk between AMPK and SIRT1. Additional data using genetically modified cells with ...
Highly Active Antiretroviral Therapy: Drug regimens, for patients with HIV INFECTIONS, that aggressively suppress HIV replication. The regimens usually involve administration of three or more different drugs including a protease inhibitor.
We investigated whether therapeutic vaccination in highly active antiretroviral therapy (HAART)-treated patients with a modified vaccinia virus Ankara-vectored HIV-1 vaccine, with or without therapy interruption, induced the production of interleukin (IL)-10. Plasma IL-10 levels were not significantly increased postvaccination, but increased in parallel with viraemia in patients who interrupted therapy. Surprisingly, IL-10 blockade augmented HIV-specific T cell proliferative responses in HAART-suppressed patients but had no effect once virological control was lost. Modulation of IL-10 might enhance vaccine-induced immune responses.
TY - JOUR. T1 - Predicting Viral Failure in Human Immunodeficiency Virus Perinatally Infected Youth with Persistent Low-Level Viremia on Highly Active Antiretroviral Therapy. AU - Pereira, Ruth. AU - Ludwig, David A.. AU - Mathew, Sunil. AU - Flores, Claudia. AU - Dominguez, Sady. AU - Gonzalez, Ivan. AU - Rivera-Hernandez, Delia. AU - Scott, Gwendolyn B.. AU - Mitchell, Charles D.. PY - 2019/1/18. Y1 - 2019/1/18. N2 - Background: Less than optimal adherence with antiretroviral therapy occurs commonly among human immunodeficiency virus HIV)-infected youth. In this study, our object was to identify patterns in the prefailure measurement of viral load (VL) that can reliably predict virological failure (VF) in HIV perinatally infected youth on highly active antiretroviral therapy (HAART). Methods: We conducted a retrospective chart review of HIV-infected youth with low-level viremia (LLV), defined as an HIV VL between the lower limits of detection (20-75 copies/mL) and 1000 copies/mL. All patients ...
Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV. Genetic analysis of HIV-1 samples from Spain
NK., Wang YM, Wang B, Dyer WB, Lachireddy K, Peng NK, Saksena (2007) Evidence for predominance of CCR5 HIV-1 strains during highly active antiretroviral therapy. Curr HIV Res., 5(2). 221-34.. Full text not available from this repository ...
BACKGROUND:Accurately estimating rates of disease progression is of central importance in developing mathematical models used to project outcomes and guide resource allocation decisions. Our objective was to specify a multivariate regression model to estimate changes in disease progression among individuals on highly active antiretroviral treatment in British Columbia, Canada, 1996-2011.
This study assessed the effects of low-dose somatropin therapy on immune reponse and fat morphology in HIV infected patients taking highly active antiretroviral
1. PalmerS, MaldarelliF, WiegandA, BernsteinB, HannaGJ, et al. (2008) Low-level viremia persists for at least 7 years in patients on suppressive antiretroviral therapy. Proc Natl Acad Sci U S A 105: 3879-3884.. 2. MaldarelliF, PalmerS, KingMS, WiegandA, PolisMA, et al. (2007) ART suppresses plasma HIV-1 RNA to a stable set point predicted by pretherapy viremia. PLoS Pathog 3: e46.. 3. CoffinJM (1995) HIV population dynamics in vivo: implications for genetic variation, pathogenesis, and therapy. Science 267: 483-489.. 4. CoffinJM (1996) HIV viral dynamics. Aids 10(Suppl 3): S75-84.. 5. PerelsonAS, EssungerP, CaoY, VesanenM, HurleyA, et al. (1997) Decay characteristics of HIV-1-infected compartments during combination therapy. Nature 387: 188-191.. 6. DinosoJB, KimSY, WiegandAM, PalmerSE, GangeSJ, et al. (2009) Treatment intensification does not reduce residual HIV-1 viremia in patients on highly active antiretroviral therapy. Proc Natl Acad Sci U S A 106: 9403-9408.. 7. GandhiRT, ZhengL, BoschRJ, ...
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BioMed Research International is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies covering a wide range of subjects in life sciences and medicine. The journal is divided into 55 subject-specific sections.
This trial investigated the efficacy of lamivudine/zidovudine/abacavir [abacavir/3TC/zidovudine] and lamivudine/abacavir [abacavir/3TC] + ritonavir boosted
I bring this study to your attention for a few reasons. It underscores the efficacy of acupuncture for gastrointestinal problems in general by addressing a serious and pernicious problem in HIV patients. The gut is highly innervated, and for that reason is actually easier to affect with acupuncture than one might think. The other interesting part of this study is that they combined the relaxation response with acupuncture to see if there was any difference and it turns out that they had a synergistic effect. The biofeedback device I use in my clinic to monitor Heart Rate Variability (HRV), a measure of the relaxation response, is designed to be used as a device for patients to learn to relax. I use it as a simple monitor, to see what happens during treatment. This makes me think I should go ahead and use it as intended, with patient participation. Who knows how much better my results would be? (For info on my practice, please click here.). ...
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 ...
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 ...
TY - JOUR. T1 - The effect of HIV-1 resistance mutations after first-line virological failure on the possibility to sequence antiretroviral drugs in second-line regimens. AU - Maggiolo, Franco. AU - Ripamonti, Diego. AU - Torti, Carlo. AU - Arici, Claudio. AU - Antinori, Andrea. AU - Quiros-Roldan, Eugenia. AU - Minoli, Lorenzo. AU - Sighinolfi, Laura. AU - Nasta, Paola. AU - Suter, Fredy. PY - 2006. Y1 - 2006. N2 - Background: One of the more vigorous debates in the field of highly active antiretroviral therapy (HAART) is how to start it and what the optimal drug sequence is. Methods: A retrospective cohort analysis was performed. The aim was to evaluate which variables could influence the virological response to second-line genotypic-based HAART in patients with virological documented first-line HAART failure. A positive response was defined as a confirmed HIV RNA level AB - Background: One of the more vigorous debates in the field of highly active antiretroviral therapy (HAART) is how to ...
Retention and viral suppression in a cohort of HIV patients on antiretroviral therapy in Zambia: Regionally representative estimates using a multistage-sampling-based approach
TY - JOUR. T1 - Approach to management of clinically localized prostate cancer in patients with human immunodeficiency virus. AU - Levinson, Adam. AU - Nagler, Eli A.. AU - Lowe, Franklin C.. PY - 2005/1/1. Y1 - 2005/1/1. N2 - To evaluate the approach to management of localized prostate cancer (PCa) in patients with human immunodeficiency virus (HIV) in the highly active antiretroviral therapy era. A retrospective analysis was performed on 10 HIV-positive patients who recently presented with elevated prostate-specific antigen levels and clinically localized PCa. At the diagnosis of PCa, the average patient was 54.0 years old, had been HIV positive for 8.75 years, had a CD4 count of 417, a prostate-specific antigen level of 9.2 ng/mL, and a Gleason score of 6. Eight of the patients had risk factors for PCa - either African-American descent (n = 6) or a positive family history (n = 2). The treatment was laparoscopic radical prostatectomy in 1, potency-preserving androgen deprivation in 1, ...
Brazilian AIDS and HIV-1-seropositive patients have had free access to highly active antiretroviral therapy (HAART) since November 1996. Although secondary data based on official mortality statistics indicate a sharp decrease in AIDS mortality, few if any studies tried to estimate the prognosis for patients with HIV who have been followed from the beginning of the HAART era. An observational study, with retrospective and prospective components, was done in 233 adult HIV-1-infected subjects who were recruited in the last 10 years at the outpatient sector of the Secondary Immunodeficiencies Clinic of the Department of Dermatology, Hospital das Clinicas da FMUSP, Sao Paulo, Brazil. The definition of AIDS followed the guidelines issued by the Centers for Disease Control (CDC) in 1987. One hundred sixty patients were asymptomatic, 46 had AIDS, 24 had AIDS-related complex, and 3 presented with acute infection at study entry. Twenty-nine (18%) of the asymptomatic subjects developed AIDS during follow-up, with
Objective To evaluate differences in glucose uptake by skeletal muscle tissue and subcutaneous fat in HIV patients on highly active antiretroviral therapy (HAART) presenting with and without lipodystrophy as well as in drug-naive HIV patients using F-18-fluorodeoxyglucose (FDG) positron emission tomography ...
TY - JOUR. T1 - Experience of pain among women with advanced HIV disease. AU - Richardson, Jean L.. AU - Heikes, Bonnie. AU - Karim, Roksanna. AU - Weber, Kathleen. AU - Anastos, Kathryn. AU - Young, Mary. PY - 2009/7/1. Y1 - 2009/7/1. N2 - We evaluated pain frequency and severity in 339 women enrolled in the Womens Interagency HIV Study (WIHS). Among these, 63% were 39 years of age or younger, 17% were white, 54% African American, and 29% Hispanic; 32% did not complete high school; 58% had a CD4 less than 200; 65% had clinical AIDS; 60% were on highly active antiretroviral therapy (HAART); and 32% had a viral load of 50,000 or more. Data were collected between 1996 and 1998. Within the past 6 months 190 (56%) women experienced pain 6 or more days and 168 (50%) women indicated pain severity scores of 4 or 5 (5-point scale). Pain frequency and pain severity were not associated with age, education, ethnicity, current therapy, or location of the WIHS site. Pain frequency and severity were related ...
We report the emergence of HIV-1 mutated strains after long-term viral suppression in four patients who interrupted highly active antiretroviral therapy (HAART). In two cases, mutations pre-existed in proviral DNA before HAART interruption. All mutations were associated with resistance to nucleoside reverse transcriptase inhibitors, and three of the four patients had prolonged periods of monotherapy or dual therapy. Resistant strains may re-emerge rapidly even in patients harbouring a majority of wild-type virus in proviral DNA before treatment interruption.. In patients with undetectable viral loads and high CD4 T-cell counts, the objectives of structured treatment interruptions are to reduce the toxicity and cost of highly active antiretroviral therapy (HAART). However, in such interruptions, the risk of the re-emergence of HIV-1 mutated strains is not well established. Our objective was to study the emergence of mutated strains in HIV-1 chronically infected patients with undetectable viraemia ...
Cytopenias are the most common HIV-associated hematological abnormality. Cytopenias have been associated with several factors including sex, race/ethnicity, geographical location and comorbidities such as tuberculosis, hepatitis B infection, fever and oral candidiasis. Cytopenias become more prevalent as HIV progresses and are often fatal. Data from resource-limited settings about the prevalence and correlates of cytopenia are limited. Therefore we conducted this cross-sectional study to assess the prevalence and correlates of cytopenia among adult AIDS patients at initiation of HAART in Uganda. 400 HIV-infected subjects who were HAART-naïve or on HAART for ≤ 6 months were enrolled into the Multivitamins, HAART and HIV/AIDS Trial. Anemia was defined according to WHO guidelines as any hemoglobin concentration < 12 g/dl for non-pregnant females and < 13 g/dl for males. Leucopenia and thrombocytopenia were defined using study site laboratory reference ranges for lack of generally accepted definitions
A 39 year old HIV positive patient on HAART followed up by the authors, administered to the clinical ward of the Department of Infectious Diseases and Clinical Microbiology in Ege University Medical School with high fever, malaise, nausea and severe diarrheae. He had administered to the State Hospital the day before and was transferred to our hospital upon the detection of highly elevated liver enzymes (ALT 1558 U/L, AST 4288 U/L).. The patient was diagnosed as HIV positive one month ago and has been using HAART including zidovudine+lamivudine (2 × 1/day) and nevirapine (2 × 200 mg/day, following dose escalation) for 22 days. He was also under psychiatric control due to severe depression and has been using sertralin and diazepam for 12 days and lithium for 10 days. His baseline plasma viral RNA was ,75.000 copies/mL, baseline CD4+ T cell count 277/mm3, and liver function tests were normal. He had been asked to refer to the hospital weekly during the first month of HAART for routine tests; but ...
OBJECTIVES: To evaluate factors associated with use of HIV specialist care by women, and to determine whether medical indications for therapy validate lower rates of antiretroviral use in women not using HIV specialty care. DESIGN: Cross-sectional analysis of the 1998 interview from the HIV Epidemiology Research Study (HERS) cohort. METHODS: Data from 273 HIV-infected women in the HERS were analyzed by multiple logistic regression to calculate predictors of the use of HIV specialist care providers.
In this study we have analyzed the relationship between T-cell turnover, thymic function, and immune activation in HIV-1-infected patients, focusing on naïve CD4+ and naïve CD8+ T cells, to better understand the contribution of these various parameters to the immunologic changes seen during HIV infection and therapy. We specifically targeted a broad range of baseline viral load and CD4+ T-cell counts in order to highlight the dynamics across the spectrum of HIV infection. At baseline, naive T-cell numbers were lower in the CD4 pool compared to the CD8 pool, but no difference between the two groups was observed in the percentages of proliferating naïve T cells or in the number of TRECs. Even though a dramatic decrease in proliferation is observed for both naïve CD4+ and CD8+ T cells after the first 6 months of therapy, we found that naïve CD4+ T-cell numbers significantly increased after initiation of HAART, but naïve CD8+ T-cell numbers were only marginally affected. Baseline naïve T-cell ...