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Dual therapy in hiv childrens

Beatriz Jiménez, Talía Sainz, Laura Díaz, María José Mellado, María Luisa Navarro, Pablo Rojo, María Isabel González-Tomé, Luis Prieto, Jorge Martínez, María Isabel de José, José Tomás Ramos, María Ángeles Muñoz-Fernandez
BACKGROUND: Our aim was to determine the prevalence and risk factors associated with low bone mineral density (BMD) in vertically HIV-infected patients; and to investigate whether low BMD is related to immune activation and senescence induced by HIV infection. METHODS: A cross-sectional study was performed in 98 vertically HIV-infected patients. BMD was measured by dual-energy X-ray absorptiometry at lumbar spine. Height adjustment of BMD Z-score was performed using height-for-age Z-score...
December 21, 2016: Pediatric Infectious Disease Journal
A J Rovner, V A Stallings, R Rutstein, J I Schall, M B Leonard, B S Zemel
: It is unknown whether vitamin D supplementation positively impacts body composition and bone outcomes in children and young adults with HIV. This RCT found that despite increasing 25(OH)D concentrations, high dose vitamin D3 supplementation did not impact bone or body composition in children and young adults with HIV infection. INTRODUCTION: The objective of this paper was to determine the impact of high-dose daily cholecalciferol (vitamin D3) supplementation on body composition and bone density, structure, and strength in children and young adults with perinatally acquired (PHIV) or behaviorally acquired (BHIV) HIV infection...
January 2017: Osteoporosis International
Regina Maria Barbosa, Cristiane da Silva Cabral, Tania di Giacomo do Lago, Adriana de Araujo Pinho
BACKGROUND: In many countries, young women of reproductive age have been especially affected by the HIV epidemic, which have fostered research to better understand how HIV infection influences and shapes women´s fertility and reproductive and sexual decisions. In Brazil, few studies have focused on the impact of the HIV epidemic on contraceptive choices among women living with HIV (WLHIV). OBJECTIVE: This study evaluates the impact HIV infection may have in the access to female sterilization in Brazil, using a time-to-event analysis...
2016: PloS One
Stephen M Arpadi, Stephanie Shiau, Renate Strehlau, Faeezah Patel, Ndileka Mbete, Donald J McMahon, Jonathan J Kaufman, Ashraf Coovadia, Louise Kuhn, Michael T Yin
BACKGROUND: We investigate if switching from a ritonavir-boosted lopinavir (LPV/r)-based to an efavirenz-based antiretroviral therapy (ART) regimen is associated with beneficial bone development. METHODS: The CHANGES Bone Study follows HIV-infected children who participated in a noninferiority randomized trial in Johannesburg, South Africa evaluating the safety and efficacy of preemptive switching to efavirenz (n = 106) compared with remaining on LPV/r (n = 113)...
October 23, 2016: AIDS
Cissy Kityo, Kim Catherina Eve Sigaloff, Tamara Sonia Boender, Elizabeth Kaudha, Joshua Kayiwa, Victor Musiime, Andrew Mukuye, Mary Kiconco, Immaculate Nankya, Llilian Nakatudde-Katumba, Job C J Calis, Tobias F Rinke de Wit, Peter N Mugyenyi
BACKGROUND: There are limited data on primary human immunodeficiency virus drug resistance (HIVDR) in pediatric populations. This study aimed to assess the prevalence of primary HIVDR and associated risk factors among children initiating first-line antiretroviral therapy (ART) in Uganda. METHODS: At three Ugandan clinics, children (age <12 years) requiring ART were recruited between January 2010 and August 2011. Before starting ART, blood was collected for viral load and pol gene sequencing...
July 2016: AIDS Research and Human Retroviruses
Veronica Mulenga, Victor Musiime, Adeodata Kekitiinwa, Adrian D Cook, George Abongomera, Julia Kenny, Chisala Chabala, Grace Mirembe, Alice Asiimwe, Ellen Owen-Powell, David Burger, Helen McIlleron, Nigel Klein, Chifumbe Chintu, Margaret J Thomason, Cissy Kityo, A Sarah Walker, Diana M Gibb
BACKGROUND: WHO 2013 guidelines recommend universal treatment for HIV-infected children younger than 5 years. No paediatric trials have compared nucleoside reverse-transcriptase inhibitors (NRTIs) in first-line antiretroviral therapy (ART) in Africa, where most HIV-infected children live. We aimed to compare stavudine, zidovudine, or abacavir as dual or triple fixed-dose-combination paediatric tablets with lamivudine and nevirapine or efavirenz. METHODS: In this open-label, parallel-group, randomised trial (CHAPAS-3), we enrolled children from one centre in Zambia and three in Uganda who were previously untreated (ART naive) or on stavudine for more than 2 years with viral load less than 50 copies per mL (ART experienced)...
February 2016: Lancet Infectious Diseases
Steve Innes, Kameelah L Abdullah, Richard Haubrich, Mark F Cotton, Sara H Browne
BACKGROUND: Data describing the true extent of antiretroviral therapy (ART)-induced dyslipidemia and insulin resistance in perinatally infected children on ART in Africa are sparse. METHODS: Fasting total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, insulin and glucose were performed on the first 100 of 190 pediatric ART clinic attendees. Diet assessment was performed by a trained dietician. Lipoatrophy was formally graded by consensus between 2 expert HIV pediatricians...
January 2016: Pediatric Infectious Disease Journal
Sophie Cohen, Steve Innes, Sibyl P M Geelen, Jonathan C K Wells, Colette Smit, Tom F W Wolfs, Berthe L F van Eck-Smit, Taco W Kuijpers, Peter Reiss, Henriette J Scherpbier, Dasja Pajkrt, Madeleine J Bunders
OBJECTIVE: Longitudinal studies objectively evaluating changes in regional fat distribution of HIV-infected children assessed by whole body dual energy X-ray absorptiometry (DEXA) are scarce, whilst this long-term effect of HIV and antiretroviral therapy (cART) is an important issue in infected children in need for lifelong treatment. METHODS: We assessed regional fat distribution over time, measured with sequential DEXA-scans in HIV-infected children on cART in cohorts from South Africa (SA) and the Netherlands (NL), and in healthy controls (SA)...
2015: PloS One
Kabaye Kumela, Demisew Amenu, Legese Chelkeba
BACKGROUND: More than 90% of Human immunodeficiency virus (HIV) infection in children is acquired due to mother-to-child transmission, which is spreading during pregnancy, delivery or breastfeeding. OBJECTIVE: To determine the effectiveness of highly active antiretroviral and short course antiretroviral regimens in prevention of mother-to-child transmission of HIV and associated factors Jimma University Specialized Hospital (JUSH). METHOD: A hospital based retrospective cohort study was conducted on HIV infected pregnant mothers who gave birth and had follow up at anti-retroviral therapy (ART) clinic for at least 6 months during a time period paired with their infants...
April 2015: Pharmacy Practice
Renate Strehlau, Anamaria Pena Donati, Pedro Martinez Arce, Jurgen Lissens, Rong Yang, Sophie Biguenet, Daniela Cambilargiu, Hélène Hardy, Todd Correll
INTRODUCTION: PRINCE-1 is an ongoing prospective, international, multicentre, nonrandomized, two-stage clinical trial assessing safety and efficacy of once-daily atazanavir (ATV) powder boosted with ritonavir (RTV) liquid plus optimized dual nucleoside reverse-transcriptase inhibitor (NRTI) background therapy in antiretroviral (ARV)-naïve and -experienced children with HIV-1 infection aged ≥3 months to <6 years. METHODS: Children with HIV-1 infection without prior ATV exposure and with a screening HIV-1 RNA ≥1000 copies/mL were enrolled...
2015: Journal of the International AIDS Society
Martina Penazzato, Ken Dominguez, Mark Cotton, Linda Barlow-Mosha, Nathan Ford
BACKGROUND: This systematic review aimed to assess the safety and efficacy of antiretroviral options for postexposure prophylaxis (PEP). Recognizing the limited data on the safety and efficacy of antiretroviral drugs for PEP in children, this review was extended to include consideration of data on the use of antiretroviral drugs for treatment of infants and children living with human immunodeficiency virus. METHODS: The PEP literature was assessed to identify studies reporting safety and completion rates for children given PEP, and this information was complemented by safety and efficacy data for drugs used in antiretroviral therapy...
June 1, 2015: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Sarah K Himes, Julia W Wu, Denise L Jacobson, Katherine Tassiopoulos, Rohan Hazra, Deborah Kacanek, Russell B Van Dyke, Kenneth C Rich, George K Siberry, Marilyn A Huestis
BACKGROUND: Maternal tenofovir disoproxil fumarate (TDF) treatment among HIV-infected pregnant women results in fetal tenofovir (TFV) exposure. Fetal TFV toxicity was demonstrated in animals, but most clinical investigations have not observed toxicity in humans. METHODS: We evaluated HIV-exposed, uninfected infants in the Surveillance Monitoring for Antiretroviral Therapy Toxicities cohort of the Pediatric HIV/AIDS Cohort Study whose mothers were prescribed TDF for ≥ 8 third trimester weeks...
August 2015: Pediatric Infectious Disease Journal
Sasmita Biswal
PURPOSE: Diarrhea and dehydration caused by enteric infections is a major factor of morbidity and mortality worldwide. Secretory diarrhea can be devastating especially among infants, children, and HIV infected people and can result in death of more than 50% of its victims for without adequate rehydration, patients are at maximum risk during the first 6-18 hours. Hence, it is a leading cause of morbidity and mortality worldwide. Diarrhea is experienced by over 50% of AIDS patients at some time or other during the course of their illness, which is an important cause of increased morbidity and mortality in them...
2014: Recent Patents on Anti-infective Drug Discovery
P Rojas Sánchez, M de Mulder, E Fernandez-Cooke, L Prieto, P Rojo, S Jiménez de Ory, M José Mellado, M Navarro, J Tomas Ramos, Á Holguín
Drug resistance mutations compromise the success of antiretroviral treatment in human immunodeficiency virus type 1 (HIV-1)-infected children. We report the virologic and clinical follow-up of the Madrid cohort of perinatally HIV-infected children and adolescents after the selection of triple-class drug-resistant mutations (TC-DRM). We identified patients from the cohort carrying HIV-1 variants with TC-DRM to nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors and protease inhibitors according to IAS-USA-2013...
June 2015: Clinical Microbiology and Infection
Tanya Rogo, Allison K DeLong, Philip Chan, Rami Kantor
BACKGROUND: Drug resistance development in the human immunodeficiency virus (HIV)-infected pediatric population in the United States can impact long-term antiretroviral therapy (ART) efficacy. Limited formularies and adherence constraints in children jeopardize lifelong-needed ART. METHODS: We examined treatment failure, drug resistance, and their correlates in ART-naive and ART-experienced children attending the pediatric HIV clinic in Rhode Island between 1991 and 2012...
May 1, 2015: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Stefano Mora, Maria Puzzovio, Vania Giacomet, Valentina Fabiano, Katia Maruca, Silvia Capelli, Pilar Nannini, Giovanni Lombardi, Gian Vincenzo Zuccotti
Reduced bone mineral density (BMD) and altered bone metabolism are common findings in HIV-infected patients. Increased bone formation has been described both in HIV-infected adults and children. Wnt ligands promote bone formation by stimulating osteoblast differentiation and their survival. Sclerostin and dickkopf factor 1 (DKK-1), Wnt antagonists, are important negative regulators of bone formation. We studied 86 HIV-infected patients whose ages ranged from 5.7 to 27.9 years. Patients were all on antiretroviral therapy, but seven who were naïve to treatment...
August 2015: Endocrine
Ute D Feucht, Anell Meyer, Mariana Kruger
BACKGROUND: The prevention of mother-to-child transmission (PMTCT) program in South Africa is now successful in ensuring HIV-free survival for most HIV-exposed children, but gaps in PMTCT coverage remain. The study objective was to identify missed opportunities for prevention of mother-to-child transmission of HIV using the four PMTCT stages outlined in National Guidelines. METHODS: This descriptive study enrolled HIV-exposed children who were below the age of 7 years and therefore born during the South African PMTCT era...
2014: BMC Public Health
Pierre Sellier, Nathalie Schnepf, Rishma Amarsy, Sarah Maylin, Martin Coutellier, Amanda Lopes, Marie-Christine Mazeron, Clara Flateau, Marjolaine Morgand, Nicole Ciraru-Vigneron, Aurore Berthe, Aude Ricbourg, Anne-Marie Dolores-Moreno, Guy Simoneau, John Evans, Safia Souak, Sophie Matheron, Stephane Mouly, Jean-Louis Benifla, François Simon, Jean-François Bergmann
INTRODUCTION: Human Immunodeficiency Virus (HIV) Mother-To-Child-Transmission (MTCT) and prevention by combined antiretroviral therapy (cART) have been extensively studied. Hepatitis B Virus (HBV) MTCT from HIV/HBV co-infected women and prevention by antiretroviral therapy with dual activity have been poorly studied. The aim of the study was to assess HBV MTCT from HIV/HBV co-infected women in a developed country with a large access to cART. MATERIALS AND METHODS: HIV/HBV co-infected pregnant women attending the Obstetrics Department from 1st January 2000 to 1st January 2012 could be included in the study (NCT02044068)...
2014: Journal of the International AIDS Society
Angela B White, Joy F Mirjahangir, Hacsi Horvath, Andrew Anglemyer, Jennifer S Read
BACKGROUND: An estimated 260,000 children under the age of 15 years acquired HIV infection in 2012. As much as 42% of mother-to-child transmission is related to breastfeeding. Antiretroviral prophylaxis for mothers or infants has the potential to prevent mother-to-child transmission of HIV through breast milk. OBJECTIVES: To determine which antiretroviral prophylactic regimens are efficacious and safe for reducing mother-to-child transmission of HIV through breastfeeding and thereby avert child morbidity and mortality...
2014: Cochrane Database of Systematic Reviews
Alamo Stella-Talisuna, Joke Bilcke, Robert Colebunders, Philippe Beutels
BACKGROUND: Socioeconomic support reduced nonretention in a community-based antiretroviral therapy (ART) program in Uganda. However, resource implications of expanding socioeconomic support are large, and cost-effectiveness analysis can inform budget priorities. We compared the incremental benefits and costs of providing education, food, or both forms of support (dual support) with existing ART services from a health care provider's perspective. METHODS: Costs and outcome data were collected from a cohort of 2371 adult patients with HIV receiving education, food, or dual support from Reach Out Mbuya between 2004 and 2010...
October 1, 2014: Journal of Acquired Immune Deficiency Syndromes: JAIDS
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