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Efavirenz

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https://www.readbyqxmd.com/read/28434406/efavirenz-based-simplification-after-successful-early-lopinavir-boosted-ritonavir-based-therapy-in-hiv-infected-children-in-burkina-faso-and-c%C3%A3-te-d-ivoire-the-monod-anrs-12206-non-inferiority-randomised-trial
#1
Désiré Lucien Dahourou, Madeleine Amorissani-Folquet, Karen Malateste, Clarisse Amani-Bosse, Malik Coulibaly, Carole Seguin-Devaux, Thomas Toni, Rasmata Ouédraogo, Stéphane Blanche, Caroline Yonaba, François Eboua, Philippe Lepage, Divine Avit, Sylvie Ouédraogo, Philippe Van de Perre, Sylvie N'Gbeche, Angèle Kalmogho, Roger Salamon, Nicolas Meda, Marguerite Timité-Konan, Valériane Leroy
BACKGROUND: The 2016 World Health Organization guidelines recommend all children <3 years start antiretroviral therapy (ART) on protease inhibitor-based regimens. But lopinavir/ritonavir (LPV/r) syrup has many challenges in low-income countries, including limited availability, requires refrigeration, interactions with anti-tuberculous drugs, twice-daily dosing, poor palatability in young children, and higher cost than non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. Successfully initiating LPV/r-based ART in HIV-infected children aged <2 years raises operational challenges that could be simplified by switching to a protease inhibitor-sparing therapy based on efavirenz (EFV), although, to date, EFV is not recommended in children <3 years...
April 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28426519/toward-a-universal-antiretroviral-regimen-special-considerations-of-pregnancy-and-breast-feeding
#2
Amy L Slogrove, Polly Clayden, Elaine J Abrams
PURPOSE OF REVIEW: As optimized antiretroviral therapy (ART) regimens are prepared for introduction in low-income and middle-income countries (LMIC), we consider the current evidence related to dosing, efficacy and safety during pregnancy and breastfeeding of next-generation first-line and second-line ART regimens proposed for imminent introduction in the global marketplace. RECENT FINDINGS: Pregnancy pharmacokinetic considerations include potentially insufficient efavirenz exposure if dosed at 400 mg/day, the need for twice daily darunavir dosing and the paucity of data related to tenofovir alafenamide and dolutegravir dosing, safety and efficacy...
April 19, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28423949/intranasal-chitosan-g-hp%C3%AE-cd-nanoparticles-of-efavirenz-for-the-cns-targeting
#3
Aarti Belgamwar, Shagufta Khan, Pramod Yeole
Incompetence of antiretrovirals (ARV) in complete eradication of HIV from the CNS is the biggest issue in neuro-AIDS treatment. The ineffectiveness is largely due to the poor penetration of ARV. Hence, the present study is attempted to enhance the CNS uptake of efavirenz (EFV) by designing intranasal EFV nanoparticles (EFV-NPs). EFV-NPs were fabricated using chitosan-g-HPβCD by ionic gelation method and optimized using quadratic response surface methodology (RSM) employing two-factor, five-level circumscribed central composite design...
April 19, 2017: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/28419238/antiretroviral-therapy-initiation-and-changes-in-self-reported-depression
#4
Ellen F Eaton, Ronnie M Gravett, Ashutosh R Tamhane, Michael J Mugavero
In this retrospective study of treatment-naive PLWH initiating antiretroviral therapy, the score for the depression scale of the Patient Health Questionnaire (PHQ-9) was significantly higher at baseline (median, 6.0; interquartile range, 2-11) than at 12 months (3.0; 0-8; P < .001). Baseline depression and lack of insurance are associated with 12-month depression, but receipt of efavirenz-based antiretroviral therapy is not.
April 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28419200/switching-to-efavirenz-versus-remaining-on-ritonavir-boosted-lopinavir-in-hiv-infected-children-exposed-to-nevirapine-long-term-outcomes-of-a-randomized-trial
#5
Pamela M Murnane, Renate Strehlau, Stephanie Shiau, Faeezah Patel, Ndileke Mbete, Gillian Hunt, Elaine J Abrams, Ashraf Coovadia, Louise Kuhn
Background: We previously demonstrated the non-inferiority of switching to efavirenz (EFV) versus remaining on ritonavir-boosted lopinavir (LPV/r) for virologic control in HIV-infected children exposed to nevirapine (NVP) for prevention of mother-to-child transmission. Here we assess outcomes up to four years post-randomization. Methods: From 2010-2013, 298 NVP-exposed HIV-infected children ≥3 years of age were randomized to switch to EFV or remain on LPV/r in Johannesburg, South Africa (Clinicaltrials...
April 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28410249/when-could-new-antiretrovirals-be-recommended-for-national-treatment-programmes-in-low-income-and-middle-income-countries-results-of-a-who-think-tank
#6
Marco Vitoria, Nathan Ford, Polly Clayden, Anton L Pozniak, Andrew M Hill
PURPOSE OF REVIEW: To discuss barriers and opportunities for the introduction of new antiretrovirals into national treatment programmes in low-income and middle-income countries to support further treatment scale-up. Invitees to a WHO Think Tank in February 2017 evaluated recently published results. RECENT FINDINGS: There is not sufficient clinical experience of dolutegravir (DTG), tenofovir alafenamide (TAF) or efavirenz 400 mg (EFV400) to recommend their use in pregnancy...
April 12, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28403619/insulin-like-growth-factor-is-associated-with-changes-in-body-composition-with-art-initiation
#7
Kristine M Erlandson, Suzanne P Fiorillo, Sandra Wagner Cardoso, Cynthia Rivere, Jorge Sanchez, James Hakim, Nagalingeswaran Kumarasamy, Sharlaa Badal-Fasesen, Umesh Lalloo, Johnstone J Kumwenda, Thomas B Campbell, Todd Brown
BACKGROUND: Growth hormone (GH)/insulin-like growth factor (IGF)-1 axis abnormalities have been associated with body composition changes among HIV-infected persons with wasting or lipodystrophy. Little is known of GH/IGF-1 axis alterations with ART initiation or differing ART therapies. METHODS: The AIDS Clinical Trials Group Prospective Evaluation of Antiretrovirals in Resource- Limited Settings (PEARLS) study was a prospective, randomized clinical trial of ART initiation with emtricitabine/tenofovir + efavirenz (FTC/TDF+EFV) vs lamivudine/zidovudine + efavirenz (3TC/ZDV+EFV) in HIV-1-infected individuals from resource-diverse settings...
April 12, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28403028/compatibility-of-next-generation-first-line-antiretrovirals-with-rifampicin-based-antituberculosis-therapy-in-resource-limited-settings
#8
Gary Maartens, Marta Boffito, Charles Flexner
PURPOSE OF REVIEW: Reduced dose efavirenz, dolutegravir, and/or tenofovir alafenamide (TAF) are likely to be used in the next generation of first-line antiretroviral therapy in resource limited settings, where HIV-associated tuberculosis is common. Rifampicin, which is a key component of first-line antituberculosis therapy, is a potent inducer of many drug transporters and metabolising enzymes. We reviewed the literature for potential or actual drug--drug interactions between these antiretrovirals and rifampicin...
April 11, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28390117/different-cell-cycle-modulation-in-skov-3-ovarian-cancer-cell-line-by-anti-hiv-drugs
#9
Angelica Perna, Angela Lucariello, Carmine Sellitto, Iolanda Agliata, Maria Carleo, Vincenzo Sangiovanni, Vincenzo Esposito, Germano Guerra, Luigi Cobellis, Antonio De Luca
Anti-retroviral drugs used for the treatment of Human Immunodeficiency Virus (HIV) have proven to be effective even against cancer. Drawing from this background the aim of our research project was to evaluate the effects of anti-HIV drugs that belong to the Nucleoside and Nucleotide Reverse Transcriptase Inhibitors (NRTI, abacavir and tenofovir), Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI, efavirenz and etravirine) and Protease Inhibitors (PI, darunavir) on ovarian adenocarcinoma cell line (Skov-3)...
March 26, 2017: Oncology Research
https://www.readbyqxmd.com/read/28388302/genome-wide-association-and-replication-study-of-hepatotoxicity-induced-by-antiretrovirals-alone-or-with-concomitant-anti-tuberculosis-drugs
#10
Zelalem Petros, Ming Ta Michael Lee, Atsushi Takahashi, Yanfei Zhang, Getnet Yimer, Abiy Habtewold, Ina Schuppe-Koistinen, Taisei Mushiroda, Eyasu Makonnen, Michiaki Kubo, Eleni Aklillu
Drug-induced hepatotoxicity (DIH) is a common adverse event that is associated with both antiretroviral (ARV) and anti-tuberculosis drugs (ATD). Moreover, the genetic variations predisposing ARV- and ARV-ATD-induced liver toxicity in African populations are not well investigated, despite the two diseases being the major global health problems in sub-Saharan Africa. We performed a genome-wide association study (GWAS) and replication study to identify the genetic variants linked to the risk of developing DIH due to ARV drugs alone, and ARV-ATD co-treatment in Ethiopian HIV-positive patients...
April 2017: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/28383402/comparative-effectiveness-of-single-versus-multiple-tablet-antiretroviral-therapy-regimens-in-clinical-hiv-practice
#11
Daniel R Drozd, Michael S Saag, Andrew O Westfall, William Chris Mathews, Richard Haubrich, Stephen L Boswell, Stephen R Cole, Donna Porter, Mari M Kitahata, Timothy Juday, Lisa Rosenblatt
We determined risk of virologic failure (VF) in individuals initiating tenofovir/emtricitabine/efavirenz as single versus multiple tablet regimens (MTR). We found no significant difference in the risk of VF, though did observe a trend toward more VF and M184 V mutations among persons initiating MTR. Temporal trends in care may have confounded results.
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28376825/antiretroviral-therapy-supply-chain-quality-control-and-assurance-in-improving-people-living-with-hiv-therapeutic-outcomes-in-cameroon
#12
M P Ngogang Djobet, David Singhe, Julienne Lohoue, Christopher Kuaban, Jeanne Ngogang, Ernest Tambo
BACKGROUND: Evaluation of medication efficacy and safety is an essential guarantee to successful therapeutic outcome in public health practices. However, larger distribution chain supply in developing countries such as Cameroon is often challenged by counterfeit drugs, poor manufacturing, storage and degradation leading to health and patient adverse consequences. Yet, access to supply chain management in strengthening ARVs quality assurance and outcomes remains poorly documented. More than 53,000 patients have been enrolled on free ARVs medications, but little is documented on quality assurance and validity of safety for affected populations along the supply chain management since 2008...
April 4, 2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28376815/comparison-of-six-methods-to-estimate-adherence-in-an-art-na%C3%A3-ve-cohort-in-a-resource-poor-setting-which-best-predicts-virological-and-resistance-outcomes
#13
Catherine Orrell, Karen Cohen, Rory Leisegang, David R Bangsberg, Robin Wood, Gary Maartens
BACKGROUND: Incomplete adherence to antiretroviral therapy (ART) results in virologic failure and resistance. It remains unclear which adherence measure best predicts these outcomes. We compared six patient-reported and objective adherence measures in one ART-naïve cohort in South Africa. METHODS: We recruited 230 participants from a community ART clinic and prospectively collected demographic data, CD4 count and HIV-RNA at weeks 0, 16 and 48. We quantified adherence using 3-day self-report (SR), clinic-based pill count (CPC), average adherence by pharmacy refill (PR-average), calculation of medication-free days (PR-gaps), efavirenz therapeutic drug monitoring (TDM) and an electronic adherence monitoring device (EAMD)...
April 4, 2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28370356/changes-in-bone-mineral-density-body-composition-vitamin-d-status-and-mineral-metabolism-in-urban-hiv-positive-south-african-women-over-12-months
#14
Matthew M Hamill, John M Pettifor, Kate A Ward, Shane A Norris, Ann Prentice
HIV infection and antiretroviral therapy (ART) are associated with bone loss and poor vitamin D status in Caucasian populations, though their relative roles are not known. No previous studies have examined longitudinal changes in areal bone mineral density (aBMD), measured by DXA, or in vitamin D status in HIV-positive African women. Of 247 premenopausal, urban, black African women from Soweto, South Africa, initially recruited, 187 underwent anthropometry, DXA scanning and blood and urine collections at both baseline and 12 months...
April 1, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28369419/bone-mineral-density-reductions-after-tenofovir-disoproxil-fumarate-initiation-and-changes-in-phosphaturia-a-secondary-analysis-of-actg-a5224s
#15
Samir K Gupta, Eunice Yeh, Douglas W Kitch, Todd T Brown, Charles S Venuto, Gene D Morse, Belinda Ha, Kathleen Melbourne, Grace A McComsey
Background: It is unknown if the greater reductions in bone mineral density (BMD) associated with initiation of tenofovir disoproxil fumarate compared with abacavir in previously untreated HIV-infected participants in the ACTG A5224s clinical trial were associated with potentially worsening tenofovir-related phosphaturia. Methods: We correlated changes in BMD at the hip and spine with changes in phosphaturia [transtubular reabsorption of phosphorus (TRP) and tubular maximum phosphate reabsorption per glomerular filtration rate (TmP/GFR)] from entry through week 96 in those initiating tenofovir ( n  =   134) versus abacavir ( n  =   135) with efavirenz or atazanavir/ritonavir in A5224s...
March 20, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28365075/determination-of-endocrine-disrupting-chemicals-and-antiretroviral-compounds-in-surface-water-a-disposable-sorptive-sampler-with-comprehensive-gas-chromatography-time-of-flight-mass-spectrometry-and-large-volume-injection-with-ultra-high-performance-liquid
#16
Madelien Wooding, Egmont R Rohwer, Yvette Naudé
Many rural dwellers and inhabitants of informal settlements in South Africa are without access to treated water and collect untreated water from rivers and dams for personal use. Endocrine disrupting chemicals (EDCs) have been detected in surface water and wildlife of South Africa. EDCs are often present in complex environmental matrices at ultra-trace levels complicating detection thereof. We report a simplified multi-residue approach for the detection and quantification of EDCs, emerging EDCs, and antiretroviral drugs in surface water...
March 24, 2017: Journal of Chromatography. A
https://www.readbyqxmd.com/read/28359840/samhd1-is-active-in-cycling-cells-permissive-to-hiv-1-infection
#17
Roger Badia, Maria Pujantell, Javier Torres-Torronteras, Luis Menéndez-Arias, Ramón Martí, Albert Ruzo, Eduardo Pauls, Bonaventura Clotet, Ester Ballana, José A Esté, Eva Riveira-Muñoz
SAMHD1 is a triphosphohydrolase that restricts HIV-1 by limiting the intracellular dNTP pool required for reverse transcription. Although SAMHD1 is expressed and active/unphosphorylated in most cell lines, its restriction activity is thought to be relevant only in non-cycling cells. However, an in depth evaluation of SAMHD1 function and relevance in cycling cells is required. Here, we show that SAMHD1-induced degradation by HIV-2 Vpx affects the dNTP pool and HIV-1 replication capacity in the presence of the 3'-azido-3'-deoxythymidine (AZT) in cycling cells...
June 2017: Antiviral Research
https://www.readbyqxmd.com/read/28359213/caring-for-perinatally-hiv-infected-children-call-for-mental-care-for-the-children-and-the-caregivers
#18
Kimiyo Kikuchi, Krishna C Poudel, John Muganda Rwibasira, Adolphe Majyambere, Vincent Mutabazi, Simon Pierre Nyonsenga, Ribakare Muhayimpundu, Masamine Jimba
Antiretroviral therapy has dramatically improved the survival rate of perinatally HIV-infected children. For them to thrive, it is necessary to understand better their mental health issues. Caregivers play an important role in children's daily care and caregiver mental health may relate to children's mental health. However, this association has rarely been studied. Accordingly, the present study examined the associations between depression of caregivers and that of perinatally HIV-infected children in Kigali, Rwanda...
March 30, 2017: AIDS Care
https://www.readbyqxmd.com/read/28323755/cyp2b6-genotype-directed-dosing-is-required-for-optimal-efavirenz-exposure-in-children-3-36-months-with-hiv-infection
#19
Carolyn Bolton Moore, Edmund V Capparelli, Pearl Samson, Mutsa Bwakura-Dangarembizi, Patrick Jean-Philippe, Carol Worrell, Barbara Heckman, Lynette Purdue, Stephen A Spector, Alex Benns, William Borkowsky, Amy Loftis, Elizabeth Hawkins, Carole Wallis, Ellen G Chadwick
OBJECTIVES: To determine safety-specific, efficacy-specific and genotypic-specific dose requirements of efavirenz (EFV) in children aged 3 to less than 36 months with HIV infection. DESIGN: IMPAACT P1070 was a 24-week prospective cohort trial of EFV (as open capsules) and two nucleoside reverse transcriptase inhibitors in children with HIV infection 3 to less than 36 months without tuberculosis (Cohort 1). METHODS: CYP2B6 G516T genotype was determined, and intensive pharmacokinetics was performed at week 2...
May 15, 2017: AIDS
https://www.readbyqxmd.com/read/28321284/gynaecomastia-in-two-men-on-stable-antiretroviral-therapy-who-commenced-treatment-for-tuberculosis
#20
Jeremy D Kratz, Ahmad Y El-Shazly, Santos G Mambuque, Elpidio Demetria, Peter Veldkamp, Timothy S Anderson
Gynaecomastia is a common clinical presentation that varies from benign presentations in stages of human development to hormonal pathology, mainly due to hepatic dysfunction, malignancy, and adverse pharmacologic effects. We describe the development of significant bilateral gynaecomastia after starting treatment for pulmonary tuberculosis (TB) in two males with WHO stage III Human Immunodeficiency Virus (HIV) infection on stable antiretroviral regimens. Emerging reports suggest that distinct hepatic impairment in efavirenz metabolism modulates oestrogenic activity, which may be potentiated by anti-tuberculosis therapy...
December 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
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