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HIV drug complications

Joseph Donovan, Nguyen Hoan Phu, Nguyen Thi Hoang Mai, Le Tien Dung, Darma Imran, Erlina Burhan, Lam Hong Bao Ngoc, Nguyen Duc Bang, Do Chau Giang, Dang Thi Minh Ha, Jeremy Day, Le Thi Phuong Thao, Nguyen Tt Thuong, Nguyen Nang Vien, Ronald B Geskus, Marcel Wolbers, Raph L Hamers, Reinout van Crevel, Mugi Nursaya, Kartika Maharani, Tran Tinh Hien, Kevin Baird, Nguyen Huu Lan, Evelyne Kestelyn, Nguyen Van Vinh Chau, Guy E Thwaites
Background:  Tuberculous meningitis (TBM) is the most severe form of tuberculosis. Co-infection with HIV increases the risk of developing TBM, complicates treatment, and substantially worsens outcome. Whether corticosteroids confer a survival benefit in HIV-infected patients with TBM remains uncertain. Hepatitis is the most common drug-induced serious adverse event associated with anti-tuberculosis treatment, occurring in 20% of HIV-infected patients. The suggested concentration thresholds for stopping anti-tuberculosis drugs are not evidence-based...
2018: Wellcome Open Research
Tyler Finocchio, William Coolidge, Thomas Johnson
The management of patients with human immunodeficiency virus (HIV) can be a complicated specialty within itself, made even more complex when there are so many unanswered questions regarding the care of critically ill patients with HIV. The lack of consensus on the use of antiretroviral medications in the critically ill patient population has contributed to an ongoing clinical debate among intensivists. This review focuses on the pharmacological complications of antiretroviral therapy (ART) in the intensive care setting, specifically the initiation of ART in patients newly diagnosed with HIV, immune reconstitution inflammatory syndrome (IRIS), continuation of ART in those who were on a complete regimen prior to intensive care unit admission, barriers of drug delivery alternatives, and drug-drug interactions...
October 11, 2018: Journal of Intensive Care Medicine
Eveline Thobias Konje, Moke Tito Nyambita Magoma, Jennifer Hatfield, Susan Kuhn, Reginald S Sauve, Deborah Margret Dewey
BACKGROUND: Despite the significant benefits of early detection and management of pregnancy related complications during antenatal care (ANC) visits, not all pregnant women in Tanzania initiate ANC in a timely manner. The primary objectives of this research study in rural communities of Geita district, Northwest Tanzania were: 1) to conduct a population-based study that examined the utilization and availability of ANC services; and 2) to explore the challenges faced by women who visited ANC clinics and barriers to utilization of ANC among pregnant women...
October 5, 2018: BMC Pregnancy and Childbirth
Sarah MacCarthy, Uzaib Saya, Clare Samba, Josephine Birungi, Stephen Okoboi, Sebastian Linnemayr
BACKGROUND: Studies from sub-Saharan Africa (SSA) document how barriers to ART adherence present additional complications among adolescents and young adults living with HIV. We qualitatively explored barriers to ART adherence in Uganda among individuals age 14-24 to understand the unique challenges faced by this age group. METHODS: We conducted focus group (FG) discussions with Community Advisory Board members (n = 1), health care providers (n = 2), and male and female groups of adolescents age 14-17 (n = 2) and youth age 18-24 (n = 2) in Kampala, Uganda...
October 4, 2018: BMC Public Health
Alexander Kay, Anthony J Garcia-Prats, Anna Maria Mandalakas
PURPOSE OF REVIEW: The detrimental synergy of colliding HIV and tuberculosis (TB) epidemics is most devastating among children and adolescents living with HIV (CALWH) who shoulder a disproportionate burden of all child TB mortality. RECENT FINDINGS: CALWH benefit less from Bacille-Calmette Guerin vaccination than HIV-uninfected children and are not receiving TB preventive therapy despite global recommendations. Further, the predictive utility of most diagnostic tools is reduced in CALWH...
November 2018: Current Opinion in HIV and AIDS
Rocío M Hurtado, Daniel Meressa, Anne E Goldfeld
PURPOSE OF REVIEW: This review aims to describe the key principles in treatment of drug-resistant tuberculosis (TB) in people living with HIV, including early access to timely diagnostics, linkage into care, TB treatment strategies including the use of new and repurposed drugs, co-management of HIV disease, and treatment complications and programmatic support to optimize treatment outcomes. These are necessary strategies to decrease the likelihood of poor treatment outcomes including lower treatment completion rates and higher mortality...
November 2018: Current Opinion in HIV and AIDS
Mathieu Nacher, Gulen Ayhan, Romain Arnal, Florence Huber, Celia Basurko, Agathe Pastre, Bruno Falissard, Vincent About
PURPOSE: Penile implants or nodules are objects inserted beneath the skin of the penis mostly for erotic purposes. The procedure is painful and there may be complications. It is often associated with prison. Our objectives were to describe the prevalence of penile nodules among inmates in French Guiana, and to study factors associated with this practice, notably psychiatric diagnoses. METHODS: The study was cross-sectional. All consenting new adult prisoners incarcerated between 01/01/2014 and 31/12/2014 at the penitentiary centre of French Guiana were included...
2018: PloS One
Myint M Noe, Akriti G Jain, Sonia Shahid, Umair Majeed
Rhabdomyolysis is characterized by muscle necrosis and leakage of toxic intracellular contents into the circulatory system. It is most commonly caused by trauma, physical exertion, drugs, toxins, and a variety of infections; only rarely is it associated with acute human immunodeficiency virus (HIV) infection alone. The severity of illness ranges from asymptomatic elevations in serum muscle enzymes to life-threatening electrolyte imbalances and acute kidney injury. High HIV viral load is associated with higher muscle breakdown that increases the incidence of severe acute kidney injury and sometimes the need for renal replacement therapy...
July 24, 2018: Curēus
Nina Derby, Manjari Lal, Meropi Aravantinou, Larisa Kizima, Patrick Barnable, Aixa Rodriguez, Manshun Lai, Asa Wesenberg, Shweta Ugaonkar, Keith Levendosky, Olga Mizenina, Kyle Kleinbeck, Jeffrey D Lifson, M Melissa Peet, Zachary Lloyd, Michael Benson, Walid Heneine, Barry R O'Keefe, Melissa Robbiani, Elena Martinelli, Brooke Grasperge, James Blanchard, Agegnehu Gettie, Natalia Teleshova, José A Fernández-Romero, Thomas M Zydowsky
Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) strategies with proven in vivo efficacy rely on antiretroviral drugs, creating the potential for drug resistance and complicated treatment options in individuals who become infected. Moreover, on-demand products are currently missing from the PrEP development portfolio. Griffithsin (GRFT) is a non-antiretroviral HIV entry inhibitor derived from red algae with an excellent safety profile and potent activity in vitro. When combined with carrageenan (CG), GRFT has strong activity against herpes simplex virus-2 (HSV-2) and human papillomavirus (HPV) in vitro and in vivo...
September 24, 2018: Nature Communications
Zachery J Harter, Stuti Agarwal, Pranjali Dalvi, Norbert F Voelkel, Navneet K Dhillon
: Improved survival among HIV-1 infected individuals with the advent of antiretroviral therapy has clearly led to a greater prevalence of non-infectious complications. One of the most devastating sequelae in these individuals is the development of pulmonary arterial hypertension (PAH). Various epidemiological studies suggest a worse survival of HIV-PAH patients when compared to other forms of PAH. Given that only a subset and not all HIV-infected individuals develop HIV-PAH, suggests that an additional second hit of genetic or environmental triggers is needed for the development of PAH...
September 18, 2018: AIDS
Marcelo N Pedro, Guilherme Z Rocha, Dioze Guadagnini, Andrey Santos, Daniela O Magro, Heloisa B Assalin, Alexandre G Oliveira, Rogerio de Jesus Pedro, Mario J A Saad
Here we review how immune activation and insulin resistance contribute to the metabolic alterations observed in HIV-infected patients, and how these alterations increase the risk of developing CVD. The introduction and evolution of antiretroviral drugs over the past 25 years has completely changed the clinical prognosis of HIV-infected patients. The deaths of these individuals are now related to atherosclerotic CVDs, rather than from the viral infection itself. However, HIV infection, cART, and intestinal microbiota are associated with immune activation and insulin resistance, which can lead to the development of a variety of diseases and disorders, especially with regards to CVDs...
2018: Frontiers in Endocrinology
Fuu-Jen Tsai, Mao-Wang Ho, Chih-Ho Lai, Chen-Hsing Chou, Ju-Pi Li, Chi-Fung Cheng, Yang-Chang Wu, Xiang Liu, Hsinyi Tsang, Ting-Hsu Lin, Chiu-Chu Liao, Shao-Mei Huang, Jung-Chun Lin, Chih-Chien Lin, Ching-Liang Hsieh, Wen-Miin Liang, Ying-Ju Lin
Antiretroviral (ART) drugs has previously been associated with lipodystrophic syndrome, metabolic consequences, and neuropsychiatric complications. ART drugs include three main classes of protease inhibitors (PIs), nucleoside analog reverse transcriptase inhibitors (NRTIs), and non-nucleoside reverse transcriptase inhibitors (NNRTIs). Our previous work demonstrated that a high risk of hyperlipidemia was observed in HIV-1-infected patients who received ART drugs in Taiwan. Patients receiving ART drugs containing either Abacavir/Lamivudine (Aba/Lam; NRTI/NRTI), Lamivudine/Zidovudine (Lam/Zido; NRTI/NRTI), or Lopinavir/Ritonavir (Lop/Rit; PI) have the highest risk of hyperlipidemia...
2018: Frontiers in Pharmacology
Farah Ladak, Eugenia Socias, Seonaid Nolan, Huiru Dong, Thomas Kerr, Evan Wood, Julio Montaner, M-J Milloy
BACKGROUND: Active illicit drug use can present a barrier to the medical management of HIV infection by complicating adherence to antiretroviral therapy (ART). Plasma HIV-1 RNA viral load (VL) rebound, defined as a period of detectable HIV viral load (VL) following antiretroviral therapy (ART) and VL suppression, can lead to the generation of viral resistance and potential treatment failure. We sought to investigate the contribution of substance use patterns on rates of VL rebound. METHODS: We used data from the ACCESS study, a long-running community-recruited prospective cohort of HIV-positive people who use illicit drugs in Vancouver, Canada, a setting of universal no-cost HIV treatment...
September 19, 2018: Antiviral Therapy
Suparna Das, Jenevieve Opoku, Adam Allston, Michael Kharfen
BACKGROUND: People with HIV infection in the United States are often affected by chronic viral hepatitis. These coinfected people with either HBV or HCV are at increased risk for serious, life-threatening complications. Coinfections with viral hepatitis may also complicate the delivery of anti-retroviral therapy (ART) by escalating the risk of drug-related hepatoxicity. According to the Centers for Disease Control and Prevention (CDC), approximately 10 percent of people with HIV in the United States also have HBV, and 25 percent also have HCV coinfection...
2018: PloS One
Martin Alexander Schaller, Felix Wicke, Christian Foerch, Stefan Weidauer
PURPOSE: As a result of multilateral migration and globalization in times of humanitarian crises, western countries face a possible increase in the incidence of central nervous system tuberculosis (CNS TB). The diagnosis of CNS TB is challenging and often delayed due to the manifold and often non-specific presentation of the disease. The aim of this review is to analyze and summarize imaging features and correlated clinical findings of CNS TB. METHODS: The different manifestations of CNS TB are explained and illustrated by characteristic neuroradiological as well as neuropathological findings...
September 17, 2018: Clinical Neuroradiology
Xiuran Niu, Zhihui Gao, Shanshan Qi, Linjia Su, Nan Yang, Xiuli Luan, Jia Li, Qing Zhang, Yingli An, Sihe Zhang
Background: Successful implementation of gene therapy heavily relies on efficiently delivering genetic materials and specific targeting into cells. Oncogene-driven endocytosis stimulates nutrient uptake and also develops an endocytosis-mediated defense against therapeutic agents. Cell-penetrating peptides, typically HIV-Tat, are well known for efficient delivery of nucleic acid drugs but lack targeting specificity. Various passive targeting strategies were pursued to enhance the tumor targeting efficiency; however, they are still limited by complicated cellular endocytosis routes and the heterogeneity of cancer types...
2018: International Journal of Nanomedicine
Craig W Hendrix
FDA approved oral daily tenofovir/emtricitabine (TruvadaTM ) for pre-exposure prophylaxis of HIV infection in 2012 on the basis of two randomized controlled trials, one in men who have sex with men (MSM) and another in HIV serodiscordant heterosexual couples. Subsequently, even greater efficacy has been demonstrated in MSM with rapid, population level incidence reductions in some locations. In contrast, studies of antiretroviral PrEP in heterosexual women showed only modest or no efficacy, largely attributed to low adherence...
September 10, 2018: Clinical Pharmacology and Therapeutics
Miriam Luginbühl, Timo Junker, Dagmar I Keller
BACKGROUND: Smuggling of illegal drugs by hiding them inside one's own body, also called body packing, is a worldwide phenomenon. Cocaine is the most frequently transported drug. Body packing is a potentially lethal practice. The most serious complications of body packing are gastrointestinal obstruction or perforation and drug toxicity due to packet leakage or rupture. CASE PRESENTATION: A 30-year-old confirmed body packer was brought to our emergency department from jail because of agitation and mydriasis...
September 4, 2018: BMC Emergency Medicine
Mohammad A M Momin, Ian G Tucker, Shyamal C Das
Tuberculosis (TB) is a major global health burden. The emergence of the human immunodeficiency virus (HIV) epidemic and drug resistance has complicated global TB control. Pulmonary delivery of drugs using dry powder inhalers (DPI) is an emerging approach to treat TB. In comparison with the conventional pulmonary delivery for asthma and chronic obstructive pulmonary disease (COPD), TB requires high dose delivery to the lung. However, high dose delivery depends on the successful design of the inhaler device and the formulation of highly aerosolizable powders...
September 1, 2018: International Journal of Pharmaceutics
Jason M Bacha, Lynda C Aririguzo, Veronica Mng'ong'o, Beatrice Malingoti, Richard S Wanless, Katherine Ngo, Liane R Campbell, Gordon E Schutze
BACKGROUND: As countries scale up antiretroviral therapy (ART) for children, innovative strategies to deliver quality services to children are needed. Differentiated ART delivery models have been successful in adults, but no such program has been described in children. We describe the Standardized Pediatric Expedited Encounters for ART Drugs Initiative (SPEEDI). METHODS: Descriptive analysis of patients eligible for SPEEDI was done via retrospective review of children, adolescents, and young adults on ART at the Baylor Centre of Excellence (COE) in Mbeya, Tanzania between January 2013 and December 2015...
September 3, 2018: BMC Infectious Diseases
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