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adverse effects of Anti retroviral drugs

Ingrid J M Snijdewind, Colette Smit, Mieke H Godfried, Rachel Bakker, Jeannine F J B Nellen, Vincent W V Jaddoe, Elisabeth van Leeuwen, Peter Reiss, Eric A P Steegers, Marchina E van der Ende
BACKGROUND: The benefits of combination anti-retroviral therapy (cART) in HIV-positive pregnant women (improved maternal health and prevention of mother to child transmission [pMTCT]) currently outweigh the adverse effects due to cART. As the variety of cART increases, however, the question arises as to which type of cART is safest for pregnant women and women of childbearing age. We studied the effect of timing and exposure to different classes of cART on adverse birth outcomes in a large HIV cohort in the Netherlands...
2018: PloS One
Raghu Ramanathan, Karthikeyan Sivanesan
The HIV-infected patients are co-infected with many bacterial infections in which tuberculosis is most common found worldwide. These patients are often administered with combined therapy of anti-retroviral and anti-tubercular drugs which leads to several complications including hepatotoxicity or adverse drug interactions. The drug-drug interactions between the anti-retroviral and anti-tubercular drugs are not clearly defined and hence, this study was conducted to evaluate the pharmacokinetic drug-drug interactions of Zidovudine (AZT) with Isoniazid (INH) and its hepatotoxic metabolites...
January 1, 2017: Journal of Pharmacy Practice
Jean-Marc Steens, Didier Scherrer, Paul Gineste, P Noel Barrett, Supparatpino Khuanchai, Ratanasuwan Winai, Kiat Ruxrungtham, Jamal Tazi, Robert Murphy, Hartmut Ehrlich
We investigated the safety and antiviral effects of an anti-HIV compound (ABX464) with a unique mechanism of viral replication inhibition. This was a randomized, double-blind, placebo-controlled, dose-ranging study in treatment-naive HIV-infected patients. Participants were assigned to eight groups; each group included eight subjects receiving either the study compound, ABX464 (n = 6), or the corresponding placebo (n = 2), according to a randomization code. The first dose administered was 25 mg, given once or 3 times a day over a 2- to 3-week period...
July 2017: Antimicrobial Agents and Chemotherapy
Eric H Decloedt, Carla Freeman, Fleur Howells, Martine Casson-Crook, Maia Lesosky, Eleni Koutsilieri, Simon Lovestone, Gary Maartens, John A Joska
BACKGROUND: HIV-associated neurocognitive disorder (HAND) remains highly prevalent despite effective anti-retroviral therapy (ART). A number of adjunctive pharmacotherapies for HAND have been studied with disappointing results, but preliminary data suggest that lithium may provide clinical benefit. In addition, the low cost of lithium would facilitate access in low- and middle-income countries which carry the greatest burden of HIV. METHODS: Our objective was to evaluate the 24-week efficacy and safety of lithium in patients with moderate to severe HAND...
November 2016: Medicine (Baltimore)
O S Michael, O M Sogaolu, F A Fehintola, O M Ige, C O Falade
BACKGROUND: The combination and use of multiple drugs in the treatment of tuberculosis (TB) predispose to adverse drug events and reactions. This study evaluated the incidence, frequency, and severity of adverse events to first line anti-tuberculosis (anti-TB) drugs in patients with TB and co-infections with Human Immunodeficiency Virus (HIV). OBJECTIVE: The objective of this study was to determine the effects of HIV status on the risk of developing adverse events to first line anti-TB therapy...
June 2016: Annals of Ibadan Postgraduate Medicine
Asa Radix, Jae Sevelius, Madeline B Deutsch
INTRODUCTION: Studies have shown that transgender women (TGW) are disproportionately affected by HIV, with an estimated HIV prevalence of 19.1% among TGW worldwide. After receiving a diagnosis, HIV-positive TGW have challenges accessing effective HIV treatment, as demonstrated by lower rates of virologic suppression and higher HIV-related mortality. These adverse HIV outcomes have been attributed to the multiple sociocultural and structural barriers that negatively affect their engagement within the HIV care continuum...
2016: Journal of the International AIDS Society
Ntombenhle Gama, Kamlesh Kumar, Erik Ekengard, Matti Haukka, James Darkwa, Ebbe Nordlander, Debra Meyer
HIV infection is known for replicating in proliferating CD(+) T-cells. Treatment of these cells with cytostatic (anti-proliferation) compounds such as hydroxyurea interferes with the cells's ability support HIV replication. Combinations of such cytostatic compounds with proven anti-retroviral drugs (like ddI) are known as virostatic, and have been shown to aid in the control of the infection. The use of two different drugs in virostatic combinations however, carries the risk of adverse effects including drug-drug interactions, which could lead to augmented toxicities and reduced efficacy...
June 2016: Biometals: An International Journal on the Role of Metal Ions in Biology, Biochemistry, and Medicine
Sirirat Likanonsakul, Bussakorn Suntisuklappon, Ravee Nitiyanontakij, Wisit Prasithsirikul, Emi E Nakayama, Tatsuo Shioda, Chariya Sangsajja
BACKGROUND: In Thailand, the combined generic anti-retroviral drug stavudine/lamivudine/nevirapine (d4T/3TC/NVP) has been used to treat human immunodeficiency virus (HIV)-infected individuals since 2001. Due to relatively frequent adverse effects, d4T gradually has been replaced with tenofovir disoproxil fumarate (TDF). Although the frequency of adverse drug effects with TDF is lower than that with d4T, TDF is known to induce kidney dysfunction, especially in the proximal tubules. It has been reported that renal tubular transporters, including members of the multi-drug resistant (MDR) protein family, are implicated in tenofovir extrusion and may, therefore, confer susceptibility to TDF-induced kidney tubular dysfunction (KTD)...
2016: PloS One
Monique E Maubert, Vanessa Pirrone, Nina T Rivera, Brian Wigdahl, Michael R Nonnemacher
In many individuals, drug abuse is intimately linked with HIV-1 infection. In addition to being associated with one-third of all HIV-1 infections in the United States, drug abuse also plays a role in disease progression and severity in HIV-1-infected patients, including adverse effects on the central nervous system (CNS). Specific systems within the brain are known to be damaged in HIV-1-infected individuals and this damage is similar to that observed in drug abuse. Even in the era of anti-retroviral therapy (ART), CNS pathogenesis occurs with HIV-1 infection, with a broad range of cognitive impairment observed, collectively referred to as HIV-1-associated neurocognitive disorders (HAND)...
2015: Frontiers in Microbiology
John W Booth, Frank A Post
Acute kidney injury (AKI) is encountered commonly in HIV-positive patients admitted to the acute medical unit. The spectrum of AKI has changed in the era of combination anti-retroviral therapy, and now includes adverse effects of commonly used anti-retroviral drugs in addition to traditional precipitants such as severe sepsis or exposure to nephrotoxic antimicrobials. An accurate diagnosis requires careful integration of clinical data including volume status, history of potentially nephrotoxic exposures and consideration of immuno-virological status...
December 2015: Clinical Medicine: Journal of the Royal College of Physicians of London
H Rachadi, I Ramli, I Meknassi, B Hassam, L Benzekri
BACKGROUND: Association of sarcoidosis and HIV can occur in the context of immune reconstitution syndrome (IRS) after initiation of antiretroviral therapy (ART). Herein we report a case of cutaneous sarcoidosis in remission in an HIV-infected patient but relapsing during IRS associated with initiation of ART. PATIENTS AND METHODS: A 33-year-old female HIV-infected patient from Cameroon was treated with triple therapy with good efficacy. The patient previously had a small nodular lesion on her left cheek which disappeared spontaneously 2 months before the diagnosis of HIV infection...
December 2015: Annales de Dermatologie et de Vénéréologie
Henok Tadesse Ayele, Maaike S M van Mourik, Thomas P A Debray, Marc J M Bonten
BACKGROUND: Infection with Human Immunodeficiency virus (HIV) is an important risk factor for Tuberculosis (TB). Anti-Retroviral Therapy (ART) has improved the prognosis of HIV and reduced the risk of TB infected patients. Isoniazid Preventive Therapy (IPT) aims to reduce the development of active TB in patients with latent TB. OBJECTIVE: Systematically review and synthesize effect estimates of IPT for TB prevention in adult HIV patients. Secondary objectives were to assess the effect of IPT on HIV disease progression, all-cause mortality and adverse drug reaction (ADR)...
2015: PloS One
Teye Umanah, Jabulani Ncayiyana, Xavier Padanilam, Peter S Nyasulu
BACKGROUND: Multidrug resistant-tuberculosis (MDR-TB) is a threat to global tuberculosis control which is worsened by human immune-deficiency virus (HIV) co-infection. There is however paucity of data on the effects of antiretroviral treatment (ART) before or after starting MDR-TB treatment. This study determined predictors of mortality and treatment failure among HIV co-infected MDR-TB patients on ART. METHODS: A retrospective medical record review of 1200 HIV co-infected MDR-TB patients admitted at Sizwe Tropical Disease Hospital, Johannesburg from 2007 to 2010 was performed...
October 28, 2015: BMC Infectious Diseases
Mrinal Gupta, Heena Gupta, Anish Gupta
Cutaneous adverse reactions are a common complication of anti-retroviral therapy. Tenofovir is a newer anti-retroviral drug belonging to the nucleotide reverse transcriptase inhibitor group. Systemic adverse effects like nausea, vomiting, diarrhea, hepatotoxicity and renal toxicity are common with tenofovir but cutaneous adverse effects are rare. Lichenoid drug eruptions are a common adverse effect seen with a large variety of drugs including antimalarials, antihypertensives, nonsteroidal anti-inflammatory drugs and diuretics...
July 2015: Avicenna Journal of Medicine
Susanna Naggie, Curtis Cooper, Michael Saag, Kimberly Workowski, Peter Ruane, William J Towner, Kristen Marks, Anne Luetkemeyer, Rachel P Baden, Paul E Sax, Edward Gane, Jorge Santana-Bagur, Luisa M Stamm, Jenny C Yang, Polina German, Hadas Dvory-Sobol, Liyun Ni, Phillip S Pang, John G McHutchison, Catherine A M Stedman, Javier O Morales-Ramirez, Norbert Bräu, Dushyantha Jayaweera, Amy E Colson, Pablo Tebas, David K Wong, Douglas Dieterich, Mark Sulkowski
BACKGROUND: Effective treatment for hepatitis C virus (HCV) in patients coinfected with human immunodeficiency virus type 1 (HIV-1) remains an unmet medical need. METHODS: We conducted a multicenter, single-group, open-label study involving patients coinfected with HIV-1 and genotype 1 or 4 HCV receiving an antiretroviral regimen of tenofovir and emtricitabine with efavirenz, rilpivirine, or raltegravir. All patients received ledipasvir, an NS5A inhibitor, and sofosbuvir, a nucleotide polymerase inhibitor, as a single fixed-dose combination for 12 weeks...
August 20, 2015: New England Journal of Medicine
Woldesellassie M Bezabhe, Luke R Bereznicki, Leanne Chalmers, Peter Gee, Desalew M Kassie, Mekides A Bimirew, Gregory M Peterson
INTRODUCTION: In Ethiopia, the use of antiretroviral therapy (ART) has been scaled up for HIV/AIDS over the past decade. Adverse drug reactions (ADRs) associated with ART pose a unique challenge in the treatment of the infection in this resource-limited setting. OBJECTIVES: The aims of this study were to examine the incidence and nature of ADRs, identify the risk factors associated with the development of ADRs, and assess their impact on treatment outcomes. METHODS: A prospective cohort study was conducted in adult patients (≥18 years of age) with HIV/AIDS who commenced ART...
July 2015: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Jagdish Kathwate, Ira Shah
We describe our experience with tenofovir-based antiretroviral therapy in seven HIV-infected children after failure of first line antiretroviral drugs, or due to adverse effects to other antiretrovirals. For follow-up period of average 3.4 years, none had adverse effects or failure of treatment, indicating that tenofovir has good renal and gastrointestinal safety profile in HIV-infected Indian children and adolescents.
April 2015: Indian Pediatrics
Haryes A Funes, Ana Blas-Garcia, Juan V Esplugues, Nadezda Apostolova
BACKGROUND: The NNRTI efavirenz is among the most widely employed antiretroviral drugs. Although it is considered safe, efavirenz has been linked with several adverse effects including neurological manifestations, which appear in the majority of the patients on efavirenz-containing regimens. The molecular mechanisms responsible for these manifestations are not understood, but mounting evidence points to altered brain bioenergetics. METHODS: We evaluated the effect of short-term efavirenz treatment on the mitochondrial respiratory function of cultured glioblastoma and differentiated neuroblastoma cell lines using a Seahorse Extracellular Flux Analyzer...
August 2015: Journal of Antimicrobial Chemotherapy
Jose M Miro, Christian Manzardo, Elena Ferrer, Montserrat Loncà, Alberto C Guardo, Daniel Podzamczer, Pere Domingo, Adrian Curran, Bonaventura Clotet, Anna Cruceta, Francisco Lozano, Iñaki Pérez, Montserrat Plana, Jose M Gatell
BACKGROUND: Few randomized clinical trials have investigated antiretroviral regimens in very advanced HIV-1-infected patients. The objective was to study the immune reconstitution in very immunosuppressed antiretroviral-naive, HIV-1-infected individuals by comparing an efavirenz-based regimen with 2 ritonavir-boosted protease inhibitor regimens. METHODS: Randomized, controlled, open-label, multicenter clinical trial. Eighty-nine HIV-1-infected antiretroviral-naive patients with <100 CD4 cells per cubic millimeter were randomly assigned in a 1:1:1 ratio to efavirenz (n = 29), atazanavir/ritonavir (n = 30), or lopinavir/ritonavir (n = 30) combined with tenofovir plus emtricitabine...
June 1, 2015: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Changsuk Moon, Weiqiang Zhang, Aixia Ren, Kavisha Arora, Chandrima Sinha, Sunitha Yarlagadda, Koryse Woodrooffe, John D Schuetz, Koteswara Rao Valasani, Hugo R de Jonge, Shiva Kumar Shanmukhappa, Mohamed Tarek M Shata, Randal K Buddington, Kaushik Parthasarathi, Anjaparavanda P Naren
Diarrhea is one of the most common adverse side effects observed in ∼7% of individuals consuming Food and Drug Administration (FDA)-approved drugs. The mechanism of how these drugs alter fluid secretion in the gut and induce diarrhea is not clearly understood. Several drugs are either substrates or inhibitors of multidrug resistance protein 4 (MRP4), such as the anti-colon cancer drug irinotecan and an anti-retroviral used to treat HIV infection, 3'-azido-3'-deoxythymidine (AZT). These drugs activate cystic fibrosis transmembrane conductance regulator (CFTR)-mediated fluid secretion by inhibiting MRP4-mediated cAMP efflux...
May 1, 2015: Journal of Biological Chemistry
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