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https://www.readbyqxmd.com/read/28919303/acquisition-of-wild-type-hiv-1-infection-in-a-patient-on-pre-exposure-prophylaxis-with-high-intracellular-concentrations-of-tenofovir-diphosphate-a-case-report
#1
Elske Hoornenborg, Maria Prins, Roel C A Achterbergh, Lycke R Woittiez, Marion Cornelissen, Suzanne Jurriaans, Neeltje A Kootstra, Peter L Anderson, Peter Reiss, Henry J C de Vries, Jan M Prins, Godelieve J de Bree
BACKGROUND: Pre-exposure prophylaxis (PrEP) with emtricitabine and tenofovir disoproxil fumarate is highly effective against acquisition of HIV infection, and only two cases of infection with a multidrug-resistant virus have been reported under adequate long-term adherence, as evidenced by tenofovir diphosphate concentrations in dried blood spots. We report a case of wild-type HIV-1 infection despite consistent use of emtricitabine and tenofovir disoproxil fumarate. METHODS: The patient participated in the Amsterdam PrEP project, a demonstration project of daily and event-driven PrEP...
September 14, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28918877/raltegravir-1200-mg-once-daily-versus-raltegravir-400-mg-twice-daily-with-tenofovir-disoproxil-fumarate-and-emtricitabine-for-previously-untreated-hiv-1-infection-a-randomised-double-blind-parallel-group-phase-3-non-inferiority-trial
#2
Pedro Cahn, Richard Kaplan, Paul E Sax, Kathleen Squires, Jean-Michel Molina, Anchalee Avihingsanon, Winai Ratanasuwan, Evelyn Rojas, Mohammed Rassool, Mark Bloch, Linos Vandekerckhove, Peter Ruane, Yazdan Yazdanpanah, Christine Katlama, Xia Xu, Anthony Rodgers, Lilly East, Larissa Wenning, Sandy Rawlins, Brenda Homony, Peter Sklar, Bach-Yen Nguyen, Randi Leavitt, Hedy Teppler
BACKGROUND: Once daily regimens are preferred for HIV-1 treatment, to facilitate adherence and improve quality of life. We compared a new once daily formulation of raltegravir to the currently marketed twice daily formulation. METHODS: In this randomised, double-blind, parallel-group, phase 3, non-inferiority study, we enrolled participants aged 18 years or older with HIV-1 RNA of 1000 or more copies per mL and no previous antiretroviral treatment at 139 sites worldwide...
September 11, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28903510/changes-in-liver-steatosis-after-switching-from-efavirenz-to-raltegravir-among-human-immunodeficiency-virus-infected-patients-with-nonalcoholic-fatty-liver-disease
#3
Juan Macías, María Mancebo, Dolores Merino, Francisco Téllez, M Luisa Montes-Ramírez, Federico Pulido, Antonio Rivero-Juárez, Miguel Raffo, Montserrat Pérez-Pérez, Nicolás Merchante, Manuel Cotarelo, Juan A Pineda
Background: Antiretroviral drugs with a lower potential to induce hepatic steatosis in human immunodeficiency virus (HIV) infection need to be identified. We compared the effect of switching efavirenz (EFV) to raltegravir (RAL) on hepatic steatosis among HIV-infected patients with nonalcoholic fatty liver disease (NAFLD) receiving EFV plus 2 nucleoside analogues. Methods: HIV-infected patients on EFV plus tenofovir/emtricitabine or abacavir/lamivudine with NAFLD were randomized 1:1 to switch from EFV to RAL (400 mg twice daily), maintaining nucleoside analogues unchanged, or to continue with EFV plus 2 nucleoside analogues...
September 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28895486/iatrogenic-adrenal-insufficiency-secondary-to-combination-therapy-with-elvitegravir-cobicistat-tenofovir-disoproxil-fumarate-emtricitabine-and-interlaminar-triamcinolone-injection-in-an-aids-patient
#4
Chanie Wassner, Sutapa Maiti, Kurt Kodroff, Henry Cohen
We report the first identified case of suspected iatrogenic adrenal insufficiency after an interlaminar injection of triamcinolone acetonide while on concomitant Stribild (elvitegravir 150 mg/cobicistat 150 mg/tenofovir disoproxil fumarate 300 mg/emtricitabine 200 mg [EVG/c/TDF/FTC]). A 49-year-old female with HIV on EVG/c/TDF/FTC therapy presented to our endocrinology clinic to be evaluated for suspected Cushing syndrome. Prior to presentation, the patient had been given 2 interlaminar spinal injections of triamcinolone...
January 1, 2017: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/28895059/central-nervous-system-penetrating-antiretrovirals-impair-energetic-reserve-in-striatal-nerve-terminals
#5
Kelly L Stauch, Katy Emanuel, Benjamin G Lamberty, Brenda Morsey, Howard S Fox
The use of antiretroviral (ARV) drugs with central nervous system (CNS) penetration effectiveness (CPE) may be useful in the treatment of HIV-associated neurocognitive disorder (HAND) as well as targeting a CNS reservoir in strategies to achieve a functional cure for HIV. However, increased cognitive deficits are linked to at least one of these drugs (efavirenz). As mitochondrial dysfunction has been found with a number of ARVs, and as such can affect neuronal function, the objective of this study was to assess the effects of ARV with high CPE for toxicological profiles on presynaptic nerve terminal energy metabolism...
September 11, 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28893758/antiretroviral-therapy-for-pregnant-women-living-with-hiv-or-hepatitis-b-a-systematic-review-and-meta-analysis
#6
Reed A Siemieniuk, Farid Foroutan, Reza Mirza, Jinell Mah Ming, Paul E Alexander, Arnav Agarwal, Olufunmilayo Lesi, Arnaud Merglen, Yaping Chang, Yuan Zhang, Hassan Mir, Elliot Hepworth, Yung Lee, Dena Zeraatkar, Gordon H Guyatt
OBJECTIVE: To assess the impact of various antiretroviral/antiviral regimens in pregnant women living with HIV or hepatitis B virus (HBV). DESIGN: We performed random effects meta-analysis for HIV-related outcomes and network meta-analysis for HBV outcomes, and used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to assess quality separately for each outcome. DATA SOURCES: Embase and Medline to February 2017...
September 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28891788/week-48-resistance-analysis-of-elvitegravir-cobicistat-emtricitabine-tenofovir-df-versus-atazanavir-ritonavir-emtricitabine-tenofovir-df-in-hiv-1-infected-women-waves-study-gs-us-236-0128
#7
Rima Kulkarni, Sally L Hodder, Huyen Cao, Silvia Chang, Michael D Miller, Kirsten L White
Background Women and those with non-B subtype HIV-1 are typically underrepresented in clinical trials. WAVES (GS-US-236-0128) was a double-blind phase 3b study among treatment-naïve HIV-1-infected women that demonstrated that elvitegravir/cobicistat/emtricitabine/tenofovir DF (EVG/COBI/FTC/TDF; N = 289) was superior to atazanavir + ritonavir + FTC/TDF (ATV + RTV + FTC/TDF; N = 286) for HIV-1 RNA < 50 copies/mL by FDA snapshot analysis at week 48. Here, we describe resistance development through week 48 in women with virologic failure and determine the impact of pre-existing mutations and HIV-1 subtype on viral suppression...
July 2017: HIV Clinical Trials
https://www.readbyqxmd.com/read/28890836/new-diagnosis-of-aids-based-on-salmonella-enterica-subsp-i-enterica-enteritidis-a-meningitis-in-a-previously-immunocompetent-adult-in-the-united-states
#8
Andrew C Elton, James Levin, Matthew P Lazio
Salmonella meningitis is a rare manifestation of meningitis typically presenting in neonates and the elderly. This infection typically associates with foodborne outbreaks in developing nations and AIDS-endemic regions. We report a case of a 19-year-old male presenting with altered mental status after 3-day absence from work at a Wisconsin tourist area. He was febrile, tachycardic, and tachypneic with a GCS of 8. The patient was intubated and a presumptive diagnosis of meningitis was made. Treatment was initiated with ceftriaxone, vancomycin, acyclovir, dexamethasone, and fluid resuscitation...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28884279/primary-hiv-infection-clinical-presentation-testing-and-treatment
#9
REVIEW
Aurélia Henn, Clara Flateau, Sébastien Gallien
PURPOSE OF REVIEW: The purpose of this review was to provide current data on clinical presentation, diagnosis, and treatment of primary HIV infection (PHI). RECENT FINDINGS: In 65 to 95% of cases, PHI causes acute retroviral syndrome presenting with unspecific flu-like symptoms. Symptomatic PHI was associated with a faster clinical and immunological progression of HIV infection. Point-of-care tests remain less sensitive than fourth-generation immunoassays (IA) in PHI, especially after tenofovir-based prophylaxis use...
September 7, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28880948/prevention-of-vaginal-and-rectal-hiv-transmission-by-antiretroviral-combinations-in-humanized-mice
#10
Philippe A Gallay, Udayan Chatterji, Aaron Kirchhoff, Angel Gandarilla, Manjula Gunawardana, Richard B Pyles, Mark A Marzinke, John A Moss, Marc M Baum
With more than 7,000 new HIV infections daily worldwide, there is an urgent need for non-vaccine biomedical prevention (nBP) strategies that are safe, effective, and acceptable. Clinical trials have demonstrated that pre-exposure prophylaxis (PrEP) with antiretrovirals (ARVs) can be effective at preventing HIV infection. In contrast, other trials using the same ARVs failed to show consistent efficacy. Topical (vaginal and rectal) dosing is a promising regimen for HIV PrEP as it leads to low systematic drug exposure...
2017: PloS One
https://www.readbyqxmd.com/read/28877642/to-assess-the-success-of-computerized-order-sets-and-pharmacy-education-modules-in-improving-antiretroviral-prescribing
#11
Dhara Mehta, Bella Kohn, Michael Blumenfeld, Harold W Horowitz
PURPOSE: To assess the success of order set and pharmacist training improvement (OSPTI) in improving prescription of antiretroviral therapy (ART) in a tertiary care, public, teaching hospital. METHODS: In this pre-OSPTI (January 2012 through June 2013) and post-OSPTI study (July 2013 through September 2014), an infectious disease pharmacist reviewed all patients on ART. A review of intervention data in July 2013 led to order-set changes in the hospital's computerized order entry system for frequently intervened on antiretrovirals: ritonavir, tenofovir, emtricitabine/tenofovir disoproxil fumarate (FTC/TDF), and lamivudine...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28873128/safety-and-feasibility-of-antiretroviral-preexposure-prophylaxis-for-adolescent-men-who-have-sex-with-men-aged-15-to-17-years-in-the-united-states
#12
Sybil G Hosek, Raphael J Landovitz, Bill Kapogiannis, George K Siberry, Bret Rudy, Brandy Rutledge, Nancy Liu, D Robert Harris, Kathleen Mulligan, Gregory Zimet, Kenneth H Mayer, Peter Anderson, Jennifer J Kiser, Michelle Lally, Jennifer Brothers, Kelly Bojan, Jim Rooney, Craig M Wilson
Importance: Adolescents represent a key population for implementing preexposure prophylaxis (PrEP) interventions worldwide, yet tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) for PrEP is only licensed for adults. Objective: To examine the safety of and adherence to PrEP along with changes in sexual risk behavior among adolescent men who have sex with men (MSM). Design, Setting, and Participants: Adolescent Medicine Trials Network for HIV/AIDS Interventions 113 (Project PrEPare) was a PrEP demonstration project that evaluated the safety, tolerability, and acceptability of TDF/FTC and patterns of use, rates of adherence, and patterns of sexual risk behavior among healthy young MSM aged 15 to 17 years...
September 5, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28870148/accumulation-of-hiv-1-drug-resistance-in-patients-on-a-standard-thymidine-analogue-based-first-line-antiretroviral-therapy-after-virological-failure-implications-for-the-activity-of-next-line-regimens-from-a-longitudinal-study-in-mozambique
#13
Andrea De Luca, Zita Jorge Sidumo, Giacomo Zanelli, Noorjehan Abdul Magid, Richard Luhanga, Davide Brambilla, Giuseppe Liotta, Sandro Mancinelli, Maria Cristina Marazzi, Leonardo Palombi, Susanna Ceffa
BACKGROUND: We describe the accumulation of HIV-1 drug resistance and its effect on the activity of next-line components in patients with virological failure (HIV-1 RNA >1000 copies/mL) after 1 year (t1) of first-line antiretroviral therapy (ART) not switching to second-line drugs for one additional year (t2) in low-middle income countries (LMIC). METHODS AND RESULTS: We selected 48 patients from the DREAM cohort (Maputo, Mozambique); their median pre-ART CD4+ cell count was 165 cells/μl...
September 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28868243/highly-active-antiretroviral-therapy-dysregulates-proliferation-and-differentiation-of-human-pre-adipocytes
#14
Eyone Jones, Pavel Mazirka, Margaret A McNurlan, Frank Darras, Marie C Gelato, Giuseppe Caso
AIM: To investigate the mechanism(s) by which potential effects of multi-drug highly-active antiretroviral therapy contributes to lipodystrophy syndrome. METHODS: Preadipocytes from healthy donors were assessed for proliferation and differentiation in the presence of nucleoside reverse transcriptase inhibitors (NRTIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs), and protease inhibitors (PIs) individually and in combination. Effects on proliferation were assessed with a 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide assay and effects on differentiation were assessed from glycerol-3-phosphate dehydrogenase (GP DH) activity and quantitation of Oil Red O staining for intracellular lipid...
August 12, 2017: World Journal of Virology
https://www.readbyqxmd.com/read/28868001/efficacy-and-tolerability-of-polyphenon-e-in-difficult-to-treat-multiple-genital-warts-in-an-hiv-positive-male-subject
#15
Mauro Grandolfo, Massimo Milani
A 55-year-old man, nonsmoker, with a HIV-positive history came to our attention in February 2017. He was on treatment with Stribild(TM), 1 capsule daily (150 mg elvitegravir, 150 mg cobicistat, 200 mg emtricitabine, and 245 mg tenofovir disoproxil). The CD4+/CD8+ cellular count was 326/µL (normal values: 404-1,612); the CD3+/CD8+ cellular count was 819/µL (normal values: 220-1,219). The CD4/CD8 ratio was 0.40 (normal value: >1). Several typical genital wart lesions were present at the penis shaft and at the level of the neck and the corona of glans...
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28867499/coformulated-bictegravir-emtricitabine-and-tenofovir-alafenamide-versus-dolutegravir-with-emtricitabine-and-tenofovir-alafenamide-for-initial-treatment-of-hiv-1-infection-gs-us-380-1490-a-randomised-double-blind-multicentre-phase-3-non-inferiority-trial
#16
Paul E Sax, Anton Pozniak, M Luisa Montes, Ellen Koenig, Edwin DeJesus, Hans-Jürgen Stellbrink, Andrea Antinori, Kimberly Workowski, Jihad Slim, Jacques Reynes, Will Garner, Joseph Custodio, Kirsten White, Devi SenGupta, Andrew Cheng, Erin Quirk
BACKGROUND: Integrase strand transfer inhibitors (INSTIs) coadministered with two nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs) are recommended as first-line treatment for HIV, and coformulated fixed-dose combinations are preferred to facilitate adherence. We report 48-week results from a study comparing initial HIV-1 treatment with bictegravir-a novel INSTI with a high in-vitro barrier to resistance and low potential as a perpetrator or victim of clinically relevant drug interactions-coformulated with the NRTI combination emtricitabine and tenofovir alafenamide as a fixed-dose combination to dolutegravir administered with coformulated emtricitabine and tenofovir alafenamide...
August 31, 2017: Lancet
https://www.readbyqxmd.com/read/28867497/bictegravir-emtricitabine-and-tenofovir-alafenamide-versus-dolutegravir-abacavir-and-lamivudine-for-initial-treatment-of-hiv-1-infection-gs-us-380-1489-a-double-blind-multicentre-phase-3-randomised-controlled-non-inferiority-trial
#17
Joel Gallant, Adriano Lazzarin, Anthony Mills, Chloe Orkin, Daniel Podzamczer, Pablo Tebas, Pierre-Marie Girard, Indira Brar, Eric S Daar, David Wohl, Jürgen Rockstroh, Xuelian Wei, Joseph Custodio, Kirsten White, Hal Martin, Andrew Cheng, Erin Quirk
BACKGROUND: Integrase strand transfer inhibitors (INSTIs) are recommended components of initial antiretroviral therapy with two nucleoside reverse transcriptase inhibitors. Bictegravir is a novel, potent INSTI with a high in-vitro barrier to resistance and low potential as a perpetrator or victim of clinically relevant drug-drug interactions. We aimed to assess the efficacy and safety of bictegravir coformulated with emtricitabine and tenofovir alafenamide as a fixed-dose combination versus coformulated dolutegravir, abacavir, and lamivudine...
August 31, 2017: Lancet
https://www.readbyqxmd.com/read/28857829/were-we-prepared-for-prep-five-years-of-implementation
#18
Michael Weinstein, Otto O Yang, Adam Carl Cohen
: While the overall incidence of HIV infections in the United States (US) has decreased in recent years, certain populations remain particularly vulnerable, including racial/ethnic minorities, adolescents/young adults, and people in the southern US [1]. The Centers for Disease Control and Prevention (CDC) stated strategy to combat new infections includes a combination of "cost-effective, scalable interventions based on current science" [2]. In July 2012, the US Food and Drug Administration (FDA) approved daily oral combination tenofovir/emtricitabine ("Truvada") for pre-exposure prophylaxis (PrEP) in at-risk uninfected adults, with subsequent endorsement as blanket policy by the CDC in May 2014 [3]...
August 28, 2017: AIDS
https://www.readbyqxmd.com/read/28856025/efficacy-of-prompt-initiation-of-antiretroviral-therapy-in-the-treatment-of-hemophagocytic-lymphohistiocytosis-triggered-by-uncontrolled-human-immunodeficiency-virus
#19
Bryan P Fitzgerald, Amy L Wojciechowski, Rajinder P S Bajwa
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening, rapidly progressive hematologic disorder involving uncontrolled immune system activation. HLH has been associated with viral infections, including human immunodeficiency virus (HIV) infections. We report a case of a critically ill 30-year-old female who was hospitalized with HIV-associated HLH, with a CD4 count of 4 cells/mL and HIV viral load of 1,842,730 copies/mL. After ruling out other potential infectious causes of HLH, antiretroviral therapy (ART) was initiated with darunavir, ritonavir, tenofovir, and emtricitabine...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28828489/safety-and-tolerability-of-maraviroc-containing-regimens-to-prevent-hiv-infection-in-women-a-phase-2-randomized-trial
#20
Roy M Gulick, Timothy J Wilkin, Ying Q Chen, Raphael J Landovitz, K Rivet Amico, Alicia M Young, Paul Richardson, Mark A Marzinke, Craig W Hendrix, Susan H Eshleman, Ian McGowan, Leslie M Cottle, Adriana Andrade, Cheryl Marcus, Karin L Klingman, Wairimu Chege, Alex R Rinehart, James F Rooney, Philip Andrew, Robert A Salata, Marc Siegel, Yukari C Manabe, Ian Frank, Ken Ho, Jorge Santana, Joanne D Stekler, Shobha Swaminathan, Marybeth McCauley, Sally Hodder, Kenneth H Mayer
Background: Maraviroc (MVC) is a candidate drug for HIV preexposure prophylaxis (PrEP). Objective: To assess the safety and tolerability of MVC-containing PrEP over 48 weeks in U.S. women at risk for HIV infection. Design: Phase 2 randomized, controlled, double-blinded study of 4 antiretroviral regimens used as PrEP. (ClinicalTrials.gov: NCT01505114). Setting: 12 clinical research sites of the HIV Prevention Trials Network and AIDS Clinical Trials Group...
September 19, 2017: Annals of Internal Medicine
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