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https://www.readbyqxmd.com/read/27906017/incidence-and-risk-factors-for-liver-enzymes-elevations-in-highly-treatment-experienced-patients-switching-from-enfuvirtide-to-raltegravir-a-sub-study-of-the-anrs-138-easier-trial
#1
Nathalie de Castro, Joséphine Braun, Isabelle Charreau, Alain Lafeuillade, Jean-Paul Viard, Clotilde Allavena, Jean-Pierre Aboulker, Jean-Michel Molina
BACKGROUND: In the ANRS EASIER trial where treatment-experienced patients switched from enfuvirtide (ENF) to raltegravir (RAL), a high incidence of transaminase elevation was reported in the RAL arm. METHODS: We compared the incidence of emergent liver enzyme elevations (LEE) of grade 2 or more among patients randomized to the maintenance ENF arm or the switch RAL arm up to W24. We also assessed the overall incidence of LEE over the 48-week duration of the trial and baseline risk factors for grade 2 or more alanine aminotransferase (ALT) elevation using univariate and multivariate analyses...
April 2, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906006/integrated-therapy-for-hiv-and-tuberculosis
#2
REVIEW
Weerawat Manosuthi, Surasak Wiboonchutikul, Somnuek Sungkanuparph
Tuberculosis (TB) has been the most common opportunistic infection and cause of mortality among HIV-infected patients, especially in resource-limited countries. Clinical manifestations of TB vary and depend on the degree of immunodeficiency. Sputum microscopy and culture with drug-susceptibility testing are recommended as a standard method for diagnosing active TB. TB-related mortality in HIV-infected patients is high especially during the first few months of treatment. Integrated therapy of both HIV and TB is feasible and efficient to control the diseases and yield better survival...
May 12, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27860104/higher-rates-of-neuropsychiatric-adverse-events-leading-to-dolutegravir-discontinuation-in-women-and-older-patients
#3
C Hoffmann, T Welz, M Sabranski, M Kolb, E Wolf, H-J Stellbrink, C Wyen
OBJECTIVES: Dolutegravir (DTG), a second-generation integrase strand transfer inhibitor (INSTI), is now among the most frequently used antiretroviral agents. However, recent reports have raised concerns about potential neurotoxicity. METHODS: We performed a retrospective analysis of a cohort of HIV-infected patients who had initiated an INSTI in two large German out-patient clinics between 2007 and 2016. We compared discontinuation rates because of adverse events (AEs) within 2 years of starting treatment with dolutegravir, raltegravir or elvitegravir/cobicistat...
January 2017: HIV Medicine
https://www.readbyqxmd.com/read/27842871/trends-in-drug-resistance-associated-mutations-in-a-real-life-cohort-of-italian-patients-infected-with-hiv-1
#4
Claudia Montagna, Laura Mazzuti, Francesca Falasca, Paola Maida, Mauro Bucci, Gabriella D'Ettorre, Ivano Mezzaroma, Alessandra Fantauzzi, Nadia Alvaro, Vincenzo Vullo, Guido Antonelli, Ombretta Turriziani
Recent studies support the idea that human immunodeficiency virus type 1 (HIV-1) drug resistance is declining in developed countries. To help assess the current situation in Italy, the dynamics of drug resistance mutations in pol and integrase genes in plasma samples from HIV-1-positive patients attending Sapienza University Hospital, Rome, from 2003 to 2014 were analysed. In total, 1730 genotype resistance tests (GRTs) were retrospectively analysed. The prevalence of major drug resistance mutations (DRMs) was evaluated over time in the global population and in patients with antiretroviral therapy (ART) failure...
December 2015: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/27828875/antiretroviral-drug-use-in-a-cross-sectional-population-survey-in-africa-nimh-project-accept-hptn-043
#5
Jessica M Fogel, William Clarke, Michal Kulich, Estelle Piwowar-Manning, Autumn Breaud, Matthew T Olson, Mark A Marzinke, Oliver Laeyendecker, Agnès Fiamma, Deborah Donnell, Jessie K K Mbwambo, Linda Richter, Glenda Gray, Michael Sweat, Thomas J Coates, Susan H Eshleman
BACKGROUND: Antiretroviral (ARV) drug treatment benefits the treated individual and can prevent HIV transmission. We assessed ARV drug use in a community-randomized trial that evaluated the impact of behavioral interventions on HIV incidence. METHODS: Samples were collected in a cross-sectional survey after a 3-year intervention period. ARV drug testing was performed using samples from HIV-infected adults at four study sites (Zimbabwe; Tanzania; KwaZulu-Natal and Soweto, South Africa; survey period 2009-2011), using an assay that detects 20 ARV drugs (6 nucleoside/nucleotide reverse transcriptase inhibitors [NRTIs]; 3 non-nucleoside reverse transcriptase inhibitors [NNRTIs]; 9 protease inhibitors; maraviroc; raltegravir)...
November 3, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27815068/body-composition-and-metabolic-outcomes-after-96-weeks-of-treatment-with-ritonavir-boosted-lopinavir-plus-either-nucleoside-or-nucleotide-reverse-transcriptase-inhibitors-or-raltegravir-in-patients-with-hiv-with-virological-failure-of-a-standard-first-line
#6
Mark A Boyd, Janaki Amin, Patrick W G Mallon, Nagalingeswaran Kumarasamy, Johan Lombaard, Robin Wood, Ploenchan Chetchotisakd, Praphan Phanuphak, Lerato Mohapi, Iskandar Azwa, Waldo H Belloso, Jean-Michel Molina, Jennifer Hoy, Cecilia L Moore, Sean Emery, David A Cooper
BACKGROUND: Lipoatrophy is one of the most feared complications associated with the use of nucleoside or nucleotide reverse transcriptase inhibitors (N[t]RTIs). We aimed to assess soft-tissue changes in participants with HIV who had virological failure of a first-line antiretroviral (ART) regimen containing a non-nucleoside reverse transcriptase inhibitor plus two N(t)RTIs and were randomly assigned to receive a second-line regimen containing a boosted protease inhibitor given with either N(t)RTIs or raltegravir...
November 1, 2016: Lancet HIV
https://www.readbyqxmd.com/read/27812717/bone-mineral-density-and-vitamin-d-levels-in-hiv-treatment-na%C3%A3-ve-african-american-individuals-randomized-to-receive-hiv-drug-regimens
#7
Paul P Cook, Alexandra Te Stang, Lia R Walker, Shaw M Akula, Fiona J Cook
OBJECTIVES: Treatment of human immunodeficiency virus (HIV)-infected patients with tenofovir disoproxil fumarate is associated with a decrease in bone mineral density (BMD). Treatment with efavirenz is associated with vitamin D deficiency. We compared the effects of efavirenz, emtricitabine, and tenofovir disoproxil fumarate (EFV/FTC/TDF) with the effects of raltegravir, darunavir, and ritonavir (RAL/DRV/r) on BMD and 25-hydroxyvitamin D (25[OH]D) levels in HIV-infected, antiretroviral treatment-naïve African American subjects...
November 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27798641/switch-to-ritonavir-boosted-versus-unboosted-atazanavir-plus-raltegravir-dual-drug-therapy-leads-to-similar-efficacy-and-safety-outcomes-in-clinical-practice
#8
Pierre Gantner, Firouze Bani-Sadr, Rodolphe Garraffo, Pierre-Marie Roger, Michèle Treger, Thomas Jovelin, Pascal Pugliese, David Rey
OBJECTIVES: To assess immunovirological response, safety and pharmacokinetic of NRTI-sparing regimen dual therapy of atazanavir (ATV) and raltegravir (RAL) in maintenance strategy. METHODS: A retrospective analysis was conducted on a cohort of HIV-infected adults followed in French centers (Dat'AIDS cohort), comparing the proportions of virological and therapeutic failures between ATV + RAL and ATV/ritonavir + RAL dual therapy regimens. RESULTS: 283 patients were assessed: 185 switched for ATV + RAL and 98 for ATV/ritonavir + RAL dual therapy...
2016: PloS One
https://www.readbyqxmd.com/read/27798496/how-recent-findings-on-the-pharmacokinetics-and-pharmacodynamics-of-integrase-inhibitors-can-inform-clinical-use
#9
Emilie Elliot, Mimie Chirwa, Marta Boffito
PURPOSE OF REVIEW: This review of recent published literature and data presented at scientific meetings on integrase stand transfer inhibitors (InSTIs) examines how these findings may impact on their future clinical use. RECENT FINDINGS: Elvitegravir (EVG), raltegravir (RAL) and dolutegravir (DTG) are InSTIs recommended as first-line options for treatment naive patients by the European AIDS Clinical Society, British HIV Association, International AIDS Society-USA and DHHS...
October 27, 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/27798431/hemeoxygenase-1-as-a-novel-driver-in-ritonavir-induced-insulin-resistance-in-hiv-1-infected-patients
#10
Ninon Taylor, Iris Kremser, Simon Auer, Gregor Hoermann, Richard Greil, Elisabeth Haschke-Becher, Harald Esterbauer, Lukas Kenner, Hannes Oberkofler
BACKGROUND: Hemeoxygenase-1 (HO-1) has recently been identified as a major driver of metaflammation and obesity-related insulin resistance (IR). Drug-induced IR increases cardiovascular risk within the HIV-1-infected population receiving antiretroviral therapy (ART). We therefore investigated a possible role of HO-1 in ART-induced IR. METHODS: Effects of HIV-1 protease inhibitor ritonavir and integrase inhibitor raltegravir on expression levels of HO-1 and proinflammatory cytokines including interleukin-1β (IL-1β), IL-6, IL-8, tumor necrosis factor-α (TNFα), Chemokine (C-C motif) ligand 5 (CCL5) and monocyte chemotactic protein 1 (MCP-1) were studied in monocyte and hepatocyte cell lines...
October 27, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27779200/prevalence-of-integrase-strand-transfer-inhibitors-insti-resistance-mutations-in-taiwan
#11
Sui-Yuan Chang, Pi-Han Lin, Chien-Lin Cheng, Mao-Yuan Chen, Hsin-Yun Sun, Szu-Min Hsieh, Wang-Huei Sheng, Yi-Ching Su, Li-Hsin Su, Shu-Fang Chang, Wen-Chun Liu, Chien-Ching Hung, Shan-Chwen Chang
Antiretroviral therapy containing an integrase strand transfer inhibitor (INSTI) plus two NRTIs has become the recommended treatment for antiretroviral-naive HIV-1-infected patients in the updated guidelines. We aimed to determine the prevalence of INSTI-related mutations in Taiwan. Genotypic resistance assays were performed on plasma from ARV-naïve patients (N = 948), ARV-experienced but INSTI-naive patients (N = 359), and raltegravir-experienced patients (N = 63) from 2006 to 2015. Major INSTI mutations were defined according to the IAS-USA list and other substitutions with a Stanford HIVdb score ≧ 10 to at least one INSTI were defined as minor mutations...
October 25, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27749603/changes-in-cognitive-function-over-96-weeks-in-na%C3%A3-ve-patients-randomised-to-darunavir-ritonavir-plus-either-raltegravir-or-tenofovir-emtricitabine-a-substudy-of-the-neat001-anrs143-trial
#12
Alan Winston, Wolfgang Stöhr, Andrea Antinori, Helene Amieva, Philippe Perré, Stephane De Wit, Jacques Reynes, Mark Gompels, Antonella d'Arminio Monforte, Jose-Maria Gatell, Jesper Grarup, Anton Pozniak, Abdel Babiker, François Raffi, Laura Richert
BACKGROUND: Improvements in cognitive function are described after initiation of combination antiretroviral therapy (cART), with sparse data on differences between cART strategies. METHODS: We assessed changes in cognition, over 96 weeks, in therapy naïve HIV-positive adults randomised to darunavir/ritonavir (800/100mg once daily) with either raltegravir (400mg twice daily, Arm1) or tenofovir/emtricitabine (245/200mg once daily, Arm2). Seven cognitive tests were administered at baseline and week 96...
October 3, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27747723/postoperative-bleeding-after-administration-of-a-single-dose-of-rivaroxaban-to-a-patient-receiving-antiretroviral-therapy
#13
Carmela E Corallo, Louise Grannell, Huyen Tran
A 62-year-old man was admitted to hospital for elective revision of a left total hip arthroplasty. His history was significant for human immunodeficiency virus (HIV) infection for which he was taking the following antiretroviral agents (ARVs): etravirine, ritonavir, darunavir, raltegravir and tenofovir/emtricitabine. Rivaroxaban 10 mg daily was commenced on the second postoperative day for venous thromboembolism (VTE) prophylaxis. Approximately 24 h later, the patient developed hypotension and anaemia, accompanied by thigh swelling due to bleeding at the surgical site...
December 2015: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27746450/therapeutic-drug-monitoring-of-anti-human-immunodeficiency-virus-drugs-in-a-patient-with-short-bowel-syndrome
#14
Motoko Ikuma, Dai Watanabe, Hiroki Yagura, Misa Ashida, Masaaki Takahashi, Masaaki Shibata, Tadafumi Asaoka, Munehiro Yoshino, Tomoko Uehira, Wataru Sugiura, Takuma Shirasaka
An elderly woman with human immunodeficiency virus-1 infection developed short bowel syndrome as a result of extensive intestinal resection. Considering the possibility of poor absorption of antiretroviral drugs (ARVs), therapeutic drug monitoring (TDM) was performed. A single-dose test of 6 ARVs (darunavir, ritonavir, lopinavir, etravirine, maraviroc, and raltegravir) did not provide information on the appropriate ARV, and repeated TDM under continuous antiretroviral therapy resulted in viral suppression below 50 copies/mL, which was considered to be treatment success...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27740536/treatment-of-hiv-infection-with-a-raltegravir-based-regimen-increases-ldl-levels-but-improves-hdl-cholesterol-efflux-capacity
#15
Nicholas T Funderburg, Dihua Xu, Martin P Playford, Aditya A Joshi, Adriana Andrade, Daniel R Kuritzkes, Michael M Lederman, Nehal N Mehta
BACKGROUND: Persons infected with HIV often have altered lipid profiles that may be affected by antiretroviral therapies (ART). Traditional lipid measurements may be insufficient to assess cardiovascular disease (CVD) risk in this population. METHODS: We report results from 39 ART-naïve participants in a substudy of A5248, a single-arm study of raltegravir (RAL), emtricitabine/tenofovir administration. Samples were collected at baseline, 12, 24, and 48 weeks after ART initiation...
October 14, 2016: Antiviral Therapy
https://www.readbyqxmd.com/read/27737783/development-of-a-phenotypic-susceptibility-assay-for-hiv-1-integrase-inhibitors
#16
Eva Heger, Alexandra Andrée Theis, Klaus Remmel, Hauke Walter, Alejandro Pironti, Elena Knops, Veronica Di Cristanziano, Björn Jensen, Stefan Esser, Rolf Kaiser, Nadine Lübke
Phenotypic resistance analysis is an indispensable method for determination of HIV-1 resistance and cross-resistance to novel drug compounds. Since integrase inhibitors are essential components of recent antiretroviral combination therapies, phenotypic resistance data, in conjunction with the corresponding genotypes, are needed for improving rules-based and data-driven tools for resistance prediction, such as HIV-Grade and geno2pheno[integrase]. For generation of phenotypic resistance data to recent integrase inhibitors, a recombinant phenotypic integrase susceptibility assay was established...
October 11, 2016: Journal of Virological Methods
https://www.readbyqxmd.com/read/27733708/integrase-strand-transfer-inhibitor-associated-diabetes-mellitus-a-case-report
#17
Peter S Fong, Devon M Flynn, Christopher D Evans, P Todd Korthuis
Integrase strand transfer inhibitors (INSTIs) have become integral antiretroviral therapy (ART) agents for treating HIV infection. We report the case of a 44-year-old male with a history of hemophilia A who developed diabetes mellitus four months after switching from abacavir, lamivudine, and efavirenz to abacavir, lamivudine, and raltegravir. Hemoglobin A1C normalized without further need for exogenous insulin after raltegravir was switched back to efavirenz. In this case report, we will review a possible mechanism for INSTI-induced hyperglycemia and/or diabetes mellitus...
October 12, 2016: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/27714978/switching-regimens-in-virologically-suppressed-hiv-1-infected-patients-evidence-base-and-rationale-for-integrase-strand-transfer-inhibitor-insti-containing-regimens
#18
F Raffi, S Esser, G Nunnari, I Pérez-Valero, L Waters
In an era when most individuals with treated HIV infection can expect to live into old age, clinicians should proactively review their patients' current and future treatment needs and challenges. Clinical guidelines acknowledge that, in the setting of virological suppression, treatment switch may yield benefits in terms of tolerability, regimen simplification, adherence, convenience and long-term health considerations, particularly in the context of ageing. In this paper, we review evidence from six key clinical studies on switching virologically suppressed patients to regimens based on integrase strand transfer inhibitors (INSTIs), the antiretroviral class increasingly preferred as initial therapy in clinical guidelines...
October 2016: HIV Medicine
https://www.readbyqxmd.com/read/27708251/an-open-label-randomized-study-of-the-impact-on-insulin-sensitivity-lipid-profile-and-vascular-inflammation-by-treatment-with-lopinavir-ritonavir-or-raltegravir-in-hiv-negative-male-volunteers
#19
Paul Randell, Akil Jackson, Ana Milinkovic, Marta Boffito, Graeme Moyle
BACKGROUND: We aimed to measure the effect of raltegravir (RAL) on insulin sensitivity and surrogates of CV risk in healthy HIV-seronegative volunteers compared to that of lopinavir/r (LPV/r), a positive control. METHODS: An open label, two phase crossover study in HIV-negative male subjects randomized 1:1 to receive either 2 weeks of LPV/r followed by a two week washout period and two weeks of RAL, or RAL initially followed by LPV/r. A hyperinsulinaemic euglycaemic clamp was performed prior to and following each 2-week dosing phase...
October 6, 2016: Antiviral Therapy
https://www.readbyqxmd.com/read/27704562/efavirenz-does-not-meaningfully-affect-the-single-dose-pharmacokinetics-of-1200%C3%A2-mg-raltegravir
#20
Rajesh Krishna, Lilly East, Patrick Larson, Tara Siringhaus, Lisa Herpok, Crystal Bethel-Brown, Helen Manthos, John Brejda, Michael Gartner
Raltegravir is a human immunodeficiency virus (HIV)-1 integrase strand transfer inhibitor currently marketed at a dose of 400 mg twice daily (BID). Raltegravir for once daily regimen (QD) at a dose of 1200 mg (2 x 600 mg) is under development and offers a new treatment option for HIV-1 infected treatment-naive subjects. Since raltegravir is eliminated mainly by metabolism via an UDP-glucuronosyltransferase (UGT) 1 A1-mediated glucuronidation pathway, co-administration of UGT1A1 inducers may alter plasma levels of raltegravir...
December 2016: Biopharmaceutics & Drug Disposition
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