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https://www.readbyqxmd.com/read/29239232/effectiveness-of-single-and-multiple-tablet-antiretroviral-regimens-in-correctional-setting-for-treatment-experienced-hiv-patients
#1
Andrew Merker, Melissa Badowski, Thomas Chiampas, Sarah E Pérez, Mahesh Patel, Jeremy Young, Ryan Werner
Minimal information is available regarding antiretroviral prescribing patterns and outcomes for HIV patients in correctional systems. This study analyzes single- (STR) and multiple- (MTR) tablet regimen effectiveness in patients receiving HIV telemedicine care through the Illinois Department of Corrections (IDOC). This study involves a retrospective review of HIV-positive adult patients in IDOC on either an STR (efavirenz, rilpivirine, elvitegravir based) or an MTR (emtricitabine/tenofovir with atazanavir/ritonavir, darunavir/ritonavir, or raltegravir)...
January 1, 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/29228918/nevirapine-versus-efavirenz-based-antiretroviral-therapy-regimens-in-antiretroviral-naive-patients-with-hiv-and-tuberculosis-infections-in-india-a-multi-centre-study
#2
Sanjeev Sinha, Kartik Gupta, Srikanth Tripathy, Sahajal Dhooria, Sanjay Ranjan, R M Pandey
BACKGROUND: According to World Health Organization (WHO) guidelines, which have also been adopted by the National AIDS Control Organization (NACO), India, Efavirenz-based Anti-Retroviral Therapy (ART) is better in Human-Immunodeficiency-Virus (HIV)-infected patients who are also being treated with Rifampicin-based Anti-Tuberculous Therapy (ATT). However, Efavirenz is much more expensive. We hypothesize that Nevirapine is a cheaper alternative that possesses equal efficacy as Efavirenz in HIV-Tuberculosis (TB) co-infected patients...
December 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29220120/efavirenz-is-related-to-neuropsychiatric-symptoms-among-adults-but-not-among-adolescents-living-with-hiv-in-kilimanjaro-tanzania
#3
Marion Sumari-de Boer, Arnt Schellekens, Ashanti Duinmaijer, Julieth Munisi Lalashowi, Happiness Judical Swai, Quirijn de Mast, Andre van der Ven, Grace Kinabo
OBJECTIVES: To explore the relationship between Efavirenz (EFV) and neuropsychiatric symptoms among adults and adolescents living with HIV in Kilimanjaro, Tanzania. METHODS: Cross-sectional study among HIV-infected adults (age 18-65) and adolescents (age 12-17) on ART, attending Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania. Neuropsychiatric symptoms were measured using the Hospital Anxiety and Depression Scale (HADS), the Symptom Checklist 90 (SCL-90) and the Mini-International Neuropsychiatric Interview (MINI)...
December 8, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29211347/long-term-viral-suppression-and-immune-recovery-during-first-line-antiretroviral-therapy-a-study-of-an-hiv-infected-adult-cohort-in-hanoi-vietnam
#4
Junko Tanuma, Shoko Matsumoto, Sebastien Haneuse, Do Duy Cuong, Tuong Van Vu, Pham Thi Thanh Thuy, Nguyen Thi Dung, Nguyen Thi Hoai Dung, Nguyen Vu Trung, Nguyen Van Kinh, Shinichi Oka
INTRODUCTION: Achieving viral suppression is key in the global strategy to end the HIV epidemic. However, the levels of viral suppression have yet to be described in many resource-limited settings. METHODS: We investigated the time to virologic failure (VF; defined as a viral load of ≥1000 copies/ml) and changes in CD4 counts since starting antiretroviral therapy (ART) in a cohort of HIV-infected adults in Hanoi, Vietnam. Factors related to the time to VF and impaired early immune recovery (defined as not attaining an increase in 100 cells/mm3 in CD4 counts at 24 months) were further analysed...
December 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29210830/tenofovir-associated-nephrotoxicity-among-a-us-national-historical-cohort-of-hiv-infected-veterans-risk-modification-by-concomitant-antiretrovirals
#5
Joanne LaFleur, Adam P Bress, Stephen Esker, Kristin Knippenberg, Jacob Crook, Heather Nyman, Roger Bedimo, Pablo Tebas, Lisa Rosenblatt
BACKGROUND: Tenofovir disoproxil fumarate (TDF) has been associated with renal complications. The third agent in TDF-containing antiretroviral regimens may modify that risk. We compared renal adverse outcomes among treatment-naïve HIV-infected patients initiating TDF-containing regimens including efavirenz (EFV) or other agents. SETTING: This population-based historical cohort study used national Veterans Health Administration (VHA) clinical and administrative datasets to identify treatment-naïve HIV-infected veterans initiating antiretroviral therapy (ART) with TDF/emtricitabine (FTC)+EFV, rilpivirine (RPV), elvitegravir/cobicistat (EVG/c), or ritonavir (RTV)-boosted protease inhibitors (PIs) from 2003-2015...
November 27, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29205871/pharmacogenetic-analysis-of-the-model-based-pharmacokinetics-of-five-anti-hiv-drugs-how-does-this-influence-the-effect-of-aging
#6
Jingxian Chen, Farida S Akhtari, Michael J Wagner, Oscar Suzuki, Tim Wiltshire, Alison A Motsinger-Reif, Julie B Dumond
Analysis of aging and pharmacogenetics (PGx) on antiretroviral pharmacokinetics (PKs) could inform precision dosing for older human HIV-infected patients. Seventy-four participants receiving either atazanavir/ritonavir (ATV/RTV) or efavirenz (EFV) with tenofovir/emtricitabine (TFV/FTC) provided PK and PGx information. Aging-PGx-PK association and interaction analyses were conducted using one-way analysis of variance (ANOVA), multiple linear regression, and Random Forest ensemble methods. Our analyses associated unbound ATV disposition with multidrug resistance protein (MRP)4, RTV with P-glycoprotein (P-gp), and EFV with cytochrome P450 (CYP)2B6 and MRP4 genetic variants...
December 3, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/29199100/universal-test-and-treat-and-the-hiv-epidemic-in-rural-south-africa-a-phase-4-open-label-community-cluster-randomised-trial
#7
Collins C Iwuji, Joanna Orne-Gliemann, Joseph Larmarange, Eric Balestre, Rodolphe Thiebaut, Frank Tanser, Nonhlanhla Okesola, Thembisa Makowa, Jaco Dreyer, Kobus Herbst, Nuala McGrath, Till Bärnighausen, Sylvie Boyer, Tulio De Oliveira, Claire Rekacewicz, Brigitte Bazin, Marie-Louise Newell, Deenan Pillay, François Dabis
BACKGROUND: Universal antiretroviral therapy (ART), as per the 2015 WHO recommendations, might reduce population HIV incidence. We investigated the effect of universal test and treat on HIV acquisition at population level in a high prevalence rural region of South Africa. METHODS: We did a phase 4, open-label, cluster randomised trial of 22 communities in rural KwaZulu-Natal, South Africa. We included individuals residing in the communities who were aged 16 years or older...
November 30, 2017: Lancet HIV
https://www.readbyqxmd.com/read/29195713/generic-antiretroviral-drug-use-in-hiv-infected-patients-a-cohort-study-from-the-french-health-insurance-database
#8
Joseph Rwagitinywa, Maryse Lapeyre-Mestre, Robert Bourrel, Agnès Sommet
OBJECTIVE: This study aimed to estimate the rate of generic users among HIV-infected patients treated by antiretroviral (ARV) drugs potentially substitutable and to determine factors associated with switch from brand to generic ARV in real-life settings in a French region. METHODS: Cohort of HIV-infected patients aged of ≥18 years, exposed to at least one of the generic of lamivudine (3TC-150mg/300mg), zidovudine/lamivudine (AZT-200mg/3TC-150mg), nevirapine (NVP-200mg), efavirenz (EFV-600mg) and those exposed to brand 3TC, AZT/3TC, NVP, EFV, the fixed-dose combination abacavir/lamivudine (ABC/3TC) or the single-tablet regimen efavirenz/emtricitabine/tenofovir (EFV/FTC/TDF) as recorded in the French health insurance database between January 2012 and May 2015 were included...
November 2, 2017: Thérapie
https://www.readbyqxmd.com/read/29194389/variation-in-cyp2a6-activity-and-personalized-medicine
#9
REVIEW
Julie-Anne Tanner, Rachel F Tyndale
The cytochrome P450 2A6 (CYP2A6) enzyme metabolizes several clinically relevant substrates, including nicotine-the primary psychoactive component in cigarette smoke. The gene that encodes the CYP2A6 enzyme is highly polymorphic, resulting in extensive interindividual variation in CYP2A6 enzyme activity and the rate of metabolism of nicotine and other CYP2A6 substrates including cotinine, tegafur, letrozole, efavirenz, valproic acid, pilocarpine, artemisinin, artesunate, SM-12502, caffeine, and tyrosol. CYP2A6 expression and activity are also impacted by non-genetic factors, including induction or inhibition by pharmacological, endogenous, and dietary substances, as well as age-related changes, or interactions with other hepatic enzymes, co-enzymes, and co-factors...
December 1, 2017: Journal of Personalized Medicine
https://www.readbyqxmd.com/read/29194118/trends-in-art-prescription-durability-and-modification-new-drugs-more-changes-but-less-failure
#10
Ellen F Eaton, Ashutosh Tamhane, Thibaut Davy-Mendez, W Christopher Mathews, Richard D Moore, Michael S Saag, Michael J Mugavero
OBJECTIVE: To evaluate the real world durability of contemporary ART for treatment naïve people living with HIV (PLWH). DESIGN: A retrospective follow up study in a multisite cohort METHODS:: This study of the CNICS (CFAR Network of Integrated Clinical Systems) cohort integrates data from 8 Center for AIDS Research (CFARs). PLWH initiating ART between 2007-2014 were included. Durability was defined as time from the initiation until discontinuation/modification using Kaplan-Meier survival curves...
November 30, 2017: AIDS
https://www.readbyqxmd.com/read/29191071/allosteric-activation-of-cytochrome-p450-3a4-by-efavirenz-facilitates-midazolam-binding
#11
Tomohiko Ichikawa, Hirofumi Tsujino, Takahiro Miki, Masaya Kobayashi, Chiaki Matsubara, Sara Miyata, Taku Yamashita, Kohei Takeshita, Yasushige Yonezawa, Tadayuki Uno
1. The purpose of this study is to investigate the heteroactivation mechanism of CYP3A4 by efavirenz, which enhances metabolism of midazolam in vivo, in terms of its binding to CYP3A4 with in vitro spectroscopic methods. 2. Efavirenz exhibited a type II spectral change with binding to CYP3A4 indicating a possible inhibitor. Although dissociation constant (Kd) was approximated as 550 μM, efavirenz enhanced binding affinity of midazolam as a co-existing drug with an estimated iKd value of 5.6 µM which is comparable to a clinical concentration...
December 1, 2017: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
https://www.readbyqxmd.com/read/29190729/increased-mmab-level-in-mitochondria-as-a-novel-biomarker-of-hepatotoxicity-induced-by-efavirenz
#12
Zhimi Tan, Xiaofang Jia, Fang Ma, Yanling Feng, Hongzhou Lu, Jun-O Jin, Dage Wu, Lin Yin, Li Liu, Lijun Zhang
BACKGROUND: Efavirenz (EFV), a non-nucleoside reverse transcriptase inhibitor (NNRTI), has been widely used in the therapy of human immunodeficiency virus (HIV) infection. Some of its toxic effects on hepatic cells have been reported to display features of mitochondrial dysfunction through bioenergetic stress and autophagy, etc. However, alteration of protein levels, especially mitochondrial protein levels, in hepatic cells during treatment of EFV has not been fully investigated. METHODS: We built a cell model of EFV-induced liver toxicity through treating Huh-7 cells with different concentrations of EFV for different time followed by the analysis of cell viability using cell counting kit -8 (CCK8) and reactive oxygen species (ROS) using 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) and MitoSox dye...
2017: PloS One
https://www.readbyqxmd.com/read/29183782/impact-of-dolutegravir-and-efavirenz-on-immune-recovery-markers-results-from-a-randomized-clinical-trial
#13
Jose-Ramon Blanco, Belen Alejos, Santiago Moreno
OBJECTIVE: CD4/CD8 ratio and CD4+ T-cell percentage (CD4%) predicts the risk of AIDS and non-AIDS events. Multiple T-cell marker recovery (MTMR) has been proposed as the most complete level of immune reconstitution. In this study we quantified differences in the CD4/CD8 ratio, CD4% recovery and MTMR after starting HIV-1 treatment with DTG/ABC/3TC vs. EFV/TDF/FTC. METHODS: Exploratory post-hoc analysis of the SINGLE study, a randomized double-blind, clinical trial...
November 25, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29181714/discontinuation-of-efavirenz-in-paediatric-patients-why-do-children-switch
#14
Elke Wynberg, Eleri Williams, Gareth Tudor-Williams, Hermione Lyall, Caroline Foster
BACKGROUND: Efavirenz, a non-nucleoside reverse transcriptase inhibitor (NNRTI) is used globally as first-line antiretroviral therapy (ART) in combination with a dual nucleoside backbone in adults and children from 3 years of age. Up to 40% of adults taking efavirenz report central nervous system (CNS) adverse effects, and the rates of discontinuation of efavirenz-based treatment are higher than other first-line regimens. Data on efavirenz discontinuation are more limited for children and adolescents...
November 27, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29174084/cost-effectiveness-of-public-health-policy-options-in-the-presence-of-pretreatment-nnrti-drug-resistance-in-sub-saharan-africa-a-modelling-study
#15
Andrew N Phillips, Valentina Cambiano, Fumiyo Nakagawa, Paul Revill, Michael R Jordan, Timothy B Hallett, Meg Doherty, Andrea De Luca, Jens D Lundgren, Mutsa Mhangara, Tsitsi Apollo, John Mellors, Brooke Nichols, Urvi Parikh, Deenan Pillay, Tobias Rinke de Wit, Kim Sigaloff, Diane Havlir, Daniel R Kuritzkes, Anton Pozniak, David van de Vijver, Marco Vitoria, Mark A Wainberg, Elliot Raizes, Silvia Bertagnolio
BACKGROUND: There is concern over increasing prevalence of non-nucleoside reverse-transcriptase inhibitor (NNRTI) resistance in people initiating antiretroviral therapy (ART) in low-income and middle-income countries. We assessed the effectiveness and cost-effectiveness of alternative public health responses in countries in sub-Saharan Africa where the prevalence of pretreatment drug resistance to NNRTIs is high. METHODS: The HIV Synthesis Model is an individual-based simulation model of sexual HIV transmission, progression, and the effect of ART in adults, which is based on extensive published data sources and considers specific drugs and resistance mutations...
November 22, 2017: Lancet HIV
https://www.readbyqxmd.com/read/29170492/prediction-of-plasma-efavirenz-concentrations-among-hiv-positive-patients-taking-efavirenz-containing-combination-antiretroviral-therapy
#16
Sung-Hsi Huang, Shu-Wen Lin, Sui-Yuan Chang, Ya-Ting Lin, Chieh Chiang, Chin-Fu Hsiao, Hsin-Yun Sun, Wen-Chun Liu, Yi-Ching Su, Chien-Ching Hung, Shan-Chwen Chang
We investigated the predictors of plasma mid-dose concentrations (C12) of efavirenz by enrolling 456 HIV-positive patients who had received 2 nucleos(t)ide reverse-transcriptase inhibitors plus efavirenz (600 mg daily) for 2 weeks or longer and had their CYP2B6 516G>T polymorphism and efavirenz C12 determined. The median efavirenz C12 was 2.41 mg/L (IQR, 1.93-3.14). In analysis of covariance models, patients with CYP2B6 516GT and TT genotypes compared to those with GG genotype had higher efavirenz C12 (for GT genotype, an increase by 0...
November 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29155891/the-burden-of-gynecomastia-among-men-on-antiretroviral-therapy-in-zomba-malawi
#17
Victor Singano, Alemayehu Amberbir, Daniela Garone, Christopher Kandionamaso, Jack Msonko, Monique van Lettow, Kondwani Kalima, Yamikani Mataka, Gift Kawalazira, Gabriel Mateyu, Aunex Kwekwesa, Alfred Matengeni, Joep J van Oosterhout
BACKGROUND: Many Africans who are on life-saving ART face challenges from a variety of toxicities. After the introduction of a standardized first-line efavirenz-containing ART regimen, reports of gynecomastia appeared in Malawian popular media, however data on the prevalence and risk factors of gynecomastia from Africa are lacking. METHODS: We conducted a cross-sectional study in males ≥18 years registered on ART at the HIV clinic in Zomba Central Hospital. Men who reported to have ever experienced breast or nipple enlargement received a standard questionnaire and underwent physical examination...
2017: PloS One
https://www.readbyqxmd.com/read/29148034/role-of-p62-sqstm1-beyond-autophagy-a-lesson-learned-from-drug-induced-toxicity-in-vitro
#18
Fernando Alegre, Ángela B Moragrega, Miriam Polo, Alberto Marti-Rodrigo, Juan V Esplugues, Ana Blas-Garcia, Nadezda Apostolova
BACKGROUND AND PURPOSE: SQSTM1/p62 is a multifunctional, stress-induced, scaffold protein involved in multiple cellular processes including autophagic clearance, regulation of inflammatory responses and redox homeostasis. Alterations in its function have been associated with a long list of human pathologies such as neurodegenerative, metabolic and bone diseases (down-regulation), and cancerogenesis (up-regulation). However, its role in the off-target effects of clinically used drugs is still not understood...
November 17, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29136115/estradiol-levels-are-altered-in-human-immunodeficiency-virus-infected-pregnant-women-randomized-to-efavirenz-versus-lopinavir-ritonavir-based-antiretroviral-therapy
#19
Chloe R McDonald, Andrea L Conroy, Joel L Gamble, Eszter Papp, Michael Hawkes, Peter Olwoch, Paul Natureeba, Moses Kamya, Michael Silverman, Deborah Cohan, Catherine A Koss, Grant Dorsey, Kevin C Kain, Lena Serghides
Background: Combination antiretroviral therapy (cART) use in pregnancy has been associated with hormonal dysregulation. We performed a secondary retrospective analysis of longitudinal progesterone and estradiol levels in pregnancy using specimens from the Protease Inhibitors to Reduce Malaria Morbidity in HIV-infected Pregnant Women study, which randomized Ugandan human immunodeficiency virus (HIV)-infected ART-naive women to initiate either lopinavir/ritonavir (LPV/r)-based or efavirenz (EFV)-based cART...
November 10, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29135907/efavirenz-therapeutic-range-in-hiv-1-treatment-naive-participants
#20
Cindy J Bednasz, Charles S Venuto, Qing Ma, Eric S Daar, Paul E Sax, Margaret A Fischl, Ann C Collier, Kimberly Y Smith, Camlin Tierney, Yang Yang, Gregory E Wilding, Gene D Morse
BACKGROUND: Efavirenz is currently suggested as an alternative to recommended antiretroviral (ARV) regimens by the Department of Health and Human Services for the treatment of HIV-1 in ARV-naive patients. A mid-dosing interval therapeutic range between 1000 and 4000 ng/mL for efavirenz has been proposed in the literature, with patients more likely to experience virologic failure below this range and adverse effects above. The current study reports an analysis of virologic outcome between those above, below, or within the reported efavirenz therapeutic range (1000-4000 ng/mL) and within subgroups...
December 2017: Therapeutic Drug Monitoring
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