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https://www.readbyqxmd.com/read/28530033/concomitant-contraceptive-implant-and-efavirenz-use-in-women-living-with-hiv-perspectives-on-current-evidence-and-policy-implications-for-family-planning-and-hiv-treatment-guidelines
#1
REVIEW
Rena C Patel, Chelsea Morroni, Kimberly K Scarsi, Tabitha Sripipatana, James Kiarie, Craig R Cohen
INTRODUCTION: Preventing unintended pregnancies is important among all women, including those living with HIV. Increasing numbers of women, including HIV-positive women, choose progestin-containing subdermal implants, which are one of the most effective forms of contraception. However, drug-drug interactions between contraceptive hormones and efavirenz-based antiretroviral therapy (ART) may reduce implant effectiveness. We present four inter-related perspectives on this issue. DISCUSSION: First, as a case study, we discuss how limited data prompted country-level guidance against the use of implants among women concomitantly using efavirenz in South Africa and its subsequent negative effects on the use of implants in general...
May 11, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28523633/synthesis-comparison-and-optimization-of-a-humic-acid-quat10-polyelectrolyte-complex-by-complexation-precipitation-versus-extrusion-spheronization
#2
Margaret Siyawamwaya, Yahya E Choonara, Pradeep Kumar, Pierre P D Kondiah, Lisa C du Toit, Viness Pillay
A novel humic acid and polyquaternium-10 polyelectrolyte complex (PEC) was synthesized utilizing two methods and the solubility and permeability of efavirenz (EFV) were established. Complexation-precipitation and extrusion-spheronization were used to synthesize and compare the drug-loaded PECs. The chemical integrity, thermo-mechanical differences, and morphology between the drug-loaded PECs produced by the two methods were assessed by attenuated total reflectance-Fourier transform infrared, differential scanning calorimetry, and SEM...
May 18, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28522147/cardiovascular-risk-in-advanced-na%C3%A3-ve-hiv-infected-patients-starting-antiretroviral-therapy-comparison-of-three-different-regimens-prevaleat-ii-cohort
#3
Paolo Maggi, Chiara Bellacosa, Armando Leone, Anna Volpe, Elena Delfina Ricci, Nicoletta Ladisa, Stefania Cicalini, Elisabetta Grilli, Rosaria Viglietti, Antonio Chirianni, Lara Ines Bellazzi, Renato Maserati, Canio Martinelli, Paola Corsi, Benedetto Maurizio Celesia, Federica Sozio, Gioacchino Angarano
BACKGROUND AND AIMS: PREVALEAT (PREmature VAscular LEsions and Antiretroviral Therapy) II is a multicenter, longitudinal cohort study aimed at the evaluation of cardiovascular risk among advanced HIV-positive, treatment-naïve patients starting their first therapy. We hypothesized that these patients, present a higher cardiovascular (CV) risk. METHODS: The study included all consecutive naïve patients with less than 200 CD4 cells/ml starting antiretroviral therapy...
May 5, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28520619/late-efavirenz-induced-ataxia-and-encephalopathy-a-case-series
#4
Ebrahim Variava, Farai R Sigauke, Jennifer Norman, Modiehi Rakgokong, Petudzai Muchichwa, Andre Mochan, Gary Maartens, Neil A Martinson
BACKGROUND: WHO treatment guidelines recommend efavirenz in first line antiretroviral therapy (ART). Efavirenz commonly causes early transient neuro-psychiatric adverse events. We present 20 cases with severe encephalopathy accompanied by ataxia due to efavirenz toxicity METHODS:: Consecutive HIV-infected adults taking efavirenz-containing ART admitted to Tshepong hospital, Klerksdorp, South Africa with ataxia and encephalopathy were included in this case series. RESULTS: We identified 20 women admitted to hospital with severe ataxia...
May 17, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28520610/candidates-for-inclusion-in-a-universal-antiretroviral-regimen-dolutegravir
#5
Pedro Cahn
PURPOSE OF REVIEW: The review addresses the role of dolutegravir (DTG) in first-line therapy. In the era of test and treat, where United Nations AIDS Program and WHO have set the ambitious targets of 90/90/90, new efficacious, well tolerated, and simple therapeutic options are needed. RECENT FINDINGS: DTG has been tested in large clinical trials in treatment-naïve patients, showing noninferiority to raltegravir and superiority compared with efavirenz and ritonavir-boosted darunavir, respectively...
May 16, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28505168/development-and-validation-of-reversed-phase-hplc-gradient-method-for-the-estimation-of-efavirenz-in-plasma
#6
Shweta Gupta, Rajesh Kesarla, Narendra Chotai, Abdelwahab Omri
Efavirenz is an anti-viral agent of non-nucleoside reverse transcriptase inhibitor category used as a part of highly active retroviral therapy for the treatment of infections of human immune deficiency virus type-1. A simple, sensitive and rapid reversed-phase high performance liquid chromatographic gradient method was developed and validated for the determination of efavirenz in plasma. The method was developed with high performance liquid chromatography using Waters X-Terra Shield, RP18 50 x 4.6 mm, 3.5 μm column and a mobile phase consisting of phosphate buffer pH 3...
2017: PloS One
https://www.readbyqxmd.com/read/28505015/virologic-response-to-first-line-efavirenz-or-nevirapine-based-antiretroviral-therapy-in-hiv-infected-african-children
#7
Adeodata Kekitiinwa, Alexander J Szubert, Moira Spyer, Richard Katuramu, Victor Musiime, Tawanda Mhute, Sabrina Bakeera-Kitaka, Oscar Senfuma, Ann Sarah Walker, Diana M Gibb
BACKGROUND: Poorer virologic response to nevirapine- versus efavirenz-based antiretroviral therapy (ART) has been reported in adult systematic reviews and pediatric studies. METHODS: We compared drug discontinuation and viral load (VL) response in ART-naïve Ugandan/Zimbabwean children ≥3 years of age initiating ART with clinician-chosen nevirapine versus efavirenz in the ARROW trial. Predictors of suppression <80, <400 and <1000 copies/mL at 36, 48 and 144 weeks were identified using multivariable logistic regression with backwards elimination (P = 0...
June 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28498892/incident-aids-or-death-after-initiation-of-human-immunodeficiency-virus-treatment-regimens-including-raltegravir-or-efavirenz-among-adults-in-the-united-states
#8
Stephen R Cole, Jessie K Edwards, H Irene Hall, M Alan Brookhart, W Christopher Mathews, Richard D Moore, Heidi M Crane, Mari M Kitahata, Michael J Mugavero, Michael S Saag, Joseph J Eron
Background.: The long-term effectiveness of human immunodeficiency virus (HIV) treatments containing integrase inhibitors is unknown. Methods.: We use observational data from the Centers for AIDS Research Network of Integrated Clinical Systems and the Centers for Disease Control and Prevention to estimate 4-year risk of AIDS and all-cause mortality among 415 patients starting a raltegravir regimen compared to 2646 starting an efavirenz regimen (both regimens include emtricitabine and tenofovir disoproxil fumarate)...
June 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28497768/antibacterial-effects-of-antiretrovirals-potential-implications-for-microbiome-studies-in-hiv
#9
Mohaned Shilaih, Daniel C Angst, Alex Marzel, Sebastian Bonhoeffer, Huldrych F Günthard, Roger D Kouyos
BACKGROUND: Despite being used by more than 18 million people our understanding of the extent of effects of antiretrovirals on the human body and other organisms remains incomplete. In addition, the direct effect of antiretrovirals on the gut microbiota of HIV infected individuals has been largely overlooked in microbiome studies concerned with HIV infected individuals. METHODS: Here we tested 25 antiretrovirals on Bacillus subtilis and Escherichia coli using a broth microdilution assay to assess whether these drugs have an antibacterial effect...
May 12, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28493004/efavirenz-dissolution-enhancement-iv-antisolvent-nanocrystallization-by-sonication-physical-stability-and-dissolution
#10
Gabriela Julianelly Sartori, Livia Deris Prado, Helvécio Vinícius Antunes Rocha
Efavirenz is a fundamental drug in the HIV therapy; however, it has a low bioavailability due to low water solubility. Particle nanonization should enhance its dissolution and therefore its bioavailability. Nanocrystallization is a promising technique for preparing drug nanocrystals. A solution containing efavirenz (EFV) and methanol was added to an aqueous solution of particle stabilizers, under sonication. The adequate polymer stabilizer and its concentration and drug load were evaluated. Particle size and zeta potential of suspensions were measured...
May 10, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28492729/cyp2b6-516-g-t-polymorphism-and-side-effects-of-the-central-nervous-system-in-hiv-positive-individuals-under-efavirenz-treatment-study-of-a-sample-from-southern-brazil
#11
Talise E Müller, Joel H Ellwanger, Rafael T Michita, Maria Cristina C Matte, Jane D P Renner
This study aimed to identify the 516 G>T polymorphism of the CYP2B6 gene and evaluate its influence on central nervous system (CNS) side effect development in HIV-positive individuals undergoing Efavirenz (EFV) treatment in a population from southern Brazil. Additionally, we performed a survey on the clinical and epidemiological characteristics of our sample. In addition to medical records evaluation, whole blood of 89 individuals was analyzed for viral load, T lymphocyte count (CD4+ and CD8+), and the polymorphism...
May 4, 2017: Anais da Academia Brasileira de Ciências
https://www.readbyqxmd.com/read/28487145/unmasking-efavirenz-neurotoxicity-time-matters-to-the-underlying-mechanisms
#12
Nádia M Grilo, M João Correia, Joana P Miranda, Madalena Cipriano, Jacinta Serpa, M Matilde Marques, Emília C Monteiro, Alexandra M M Antunes, Lucília N Diogo, Sofia A Pereira
Efavirenz is an anti-HIV drug that presents relevant short- and long-term central nervous system adverse reactions. Its main metabolite (8-hydroxy-efavirenz) was demonstrated to be a more potent neurotoxin than efavirenz itself. This work was aimed to understand how efavirenz biotransformation to 8-hydroxy-efavirenz is related to its short- and long-term neuro-adverse reactions. To access those mechanisms, the expression and activity of Cyp2b enzymes as well as the thiolomic signature (low molecular weight thiols plus S-thiolated proteins) were longitudinally evaluated in the hepatic and brain tissues of rats exposed to efavirenz during 10 and 36days...
May 6, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28483965/pharmacokinetics-of-efavirenz-in-2-3-years-old-children-a-high-dose-of-25-mg-kg-per-day
#13
Claire Pressiat, Madeleine Amorissani-Folquet, Caroline Yonaba, Jean-Marc Treluyer, Désiré Lucien Dahourou, François Eboua, Stéphane Blanche, Véronique Mea-Assande, Naïm Bouazza, Frantz Foissac, Karen Malateste, Sylvie Ouedraogo, Gabrielle Lui, Valériane Leroy, Déborah Hirt
Background: The MONOD ANRS 12206 trial was designated to assess simplification of a successful LPV-based antiretroviral treatment in young HIV-infected children using efavirenz (25 mg/kg/day) to preserve the protease inhibitors class before the age of 3. In this sub-study, EFV concentrations were measured to check the consistency of a 25 mg/kg EFV dose and to compare it with the 2016 FDA recommended dose.Methods: Fifty-two children underwent blood sampling for pharmacokinetic study at 6-month and 12-month after switching to EFV...
May 8, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28481997/patterns-of-growth-body-composition-and-lipid-profiles-in-a-south-african-cohort-of-human-immunodeficiency-virus-infected-and-uninfected-children-a-cross-sectional-study
#14
Sarah M Ramteke, Stephanie Shiau, Marc Foca, Renate Strehlau, Francoise Pinillos, Faeezah Patel, Avy Violari, Afaaf Liberty, Ashraf Coovadia, Louise Kuhn, Stephen M Arpadi
Background.: Prior research in sub-Saharan Africa reports dyslipidemia in perinatally human immunodeficiency virus (HIV)-infected children receiving ritonavir-boosted lopinavir (LPV/r) compared with efavirenz; however, interpretation of findings is limited by lack of comparison data from HIV-uninfected children. Methods.: We conducted a cross-sectional analysis of lipid profiles and growth within a larger longitudinal cohort study of perinatally HIV-infected and HIV-uninfected children aged 4-9 years in Johannesburg, South Africa...
May 6, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28481785/cyp2b6-516g-t-minor-allele-protective-of-late-virologic-failure-in-efavirenz-treated-hiv-infected-patients-in-botswana
#15
Marijana Vujkovic, Scarlett L Bellamy, Athena F Zuppa, Marc Gastonguay, Ganesh S Moorthy, Bakgaki R Ratshaa, Xiaoyan Han, Andrew P Steenhoff, Mosepele Mosepele, Brian L Strom, Richard Aplenc, Gregory P Bisson, Robert Gross
BACKGROUND: CYPB2B6 polymorphisms that affect efavirenz (EFV) concentrations are common, but the effect of this polymorphism on HIV virologic failure in clinical practice settings has not fully been elucidated. Our objective was to investigate the relationship between the CYPB2B6 516G>T genotype and late virologic failure in patients treated with EFV in Gaborone, Botswana. SETTING: We performed a case-control study that included 1,338 HIV-infected black Batswana on EFV-based antiretroviral therapy (ART)...
May 5, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28478716/effect-of-valerian-in-preventing-neuropsychiatric-adverse-effects-of-efavirenz-in-hiv-positive-patients-a-pilot-randomized-placebo-controlled-clinical-trial
#16
Motahareh Ahmadi, Hossein Khalili, Ladan Abbasian, Padideh Ghaeli
BACKGROUND: Several neuropsychiatric adverse effects of efavirenz are known. Preventing these adverse effects may improve patients' adherence to antiretroviral therapy (ART). OBJECTIVES: To evaluate the efficacy and safety of valerian in preventing neuropsychiatric adverse effects of efavirenz in HIV-positive patients. METHOD: In this pilot randomized, double-blinded, placebo-controlled, clinical trial, 51 HIV-positive patients who were receiving efavirenz were recruited into the valerian (n = 25) or placebo (n = 26) group...
June 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28456686/the-dual-modulatory-effects-of-efavirenz-on-gabaa-receptors-are-mediated-via-two-distinct-sites
#17
Renqi Huang, Zhenglan Chen, Sean Dolan, John A Schetz, Glenn H Dillon
Efavirenz is a widely prescribed medicine used to treat type 1 human immunodeficiency virus (HIV-1), the most prevalent pathogenic strain of the virus responsible for the acquired immune deficiency syndrome (AIDS) pandemic. Under prescribed dosing conditions, either alone or in combination therapy, efavirenz-induced CNS disturbances are frequently reported. Efavirenz was recently reported to interact in a similar concentration range with a number of receptors, transporters and ion channels including recombinant rat α1β2γ2 GABAA receptors whose actions were potentiated (Gatch et al...
April 27, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28453849/association-between-frailty-and-components-of-the-frailty-phenotype-with-modifiable-risk-factors-and-antiretroviral-therapy
#18
Kristine M Erlandson, Kunling Wu, Susan L Koletar, Robert C Kalayjian, Ronald J Ellis, Babafemi Taiwo, Frank J Palella, Katherine Tassiopoulos
The impact of antiretroviral therapy (ART) on frailty among human immunodeficiency virus (HIV)-infected adults has not been well described. HIV-infected participants aged ≥40 years with initial ART receipt through a randomized, controlled AIDS Clinical Trials Group trial completed a frailty assessment. Ordinal logistic regression models examined factors associated with frailty. Of 1016 participants, 6% were frail, and 38% were prefrail. Frailty was associated with lower education, older age, Medicare/Medicaid, initial efavirenz, smoking, obesity, and neurocognitive impairment; physical activity and alcohol use were protective...
March 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28453240/virological-response-and-resistances-over-12-months-among-hiv-infected-children-less-than-two-years-receiving-first-line-lopinavir-ritonavir-based-antiretroviral-therapy-in-cote-d-ivoire-and-burkina-faso-the-monod-anrs-12206-cohort
#19
Clarisse Amani-Bosse, Désiré Lucien Dahourou, Karen Malateste, Madeleine Amorissani-Folquet, Malik Coulibaly, Sophie Dattez, Arlette Emieme, Mamadou Barry, Christine Rouzioux, Sylvie N'gbeche, Caroline Yonaba, Marguerite Timité-Konan, Véronique Mea, Sylvie Ouédraogo, Stéphane Blanche, Nicolas Meda, Carole Seguin-Devaux, Valériane Leroy
INTRODUCTION: Lopinavir/ritonavir-based antiretroviral therapy (ART) is recommended for all HIV-infected children less than three years. However, little is known about its field implementation and effectiveness in West Africa. We assessed the 12-month response to lopinavir/ritonavir-based antiretroviral therapy in a cohort of West African children treated before the age of two years. METHODS: HIV-1-infected, ART-naive except for a prevention of mother-to-child transmission (PMTCT), tuberculosis-free, and less than two years of age children with parent's consent were enrolled in a 12-month prospective therapeutic cohort with lopinavir/ritonavir ART and cotrimoxazole prophylaxis in Ouagadougou and Abidjan...
April 25, 2017: Journal of the International AIDS Society
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
#20
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
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