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Aida Siyahian, Saad Ullah Malik, Adeela Mushtaq, Carol L Howe, Aneela Majeed, Tirdad Zangeneh, Samar Iftikhar, Shahid Habib, Umar Zahid, Irbaz Bin Riaz, Zabih Warraich, Warda Faridi, Faiz Anwer
Patients undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT) are at a very high risk of hepatitis B virus reactivation (HBVr). Lamivudine is commonly used as prophylaxis against HBVr in high risk patients undergoing allo-HSCT. Unfortunately, its efficacy is diminishing due to the development of HBV mutant drug resistant strains. With the availability of newer antiviral agents like Entecavir, Telbivudine, Adefovir and Tenofovir, it is important to assess their role in HBVr prophylaxis. A comprehensive search of seven databases was performed to evaluate efficacy of antiviral prophylaxis against HBVr in allo-HSCT patients (PubMed/Medline, Embase, Scopus, Cochrane Library, Web of Science, CINAHL, and ClinicalTrials...
March 12, 2018: Biology of Blood and Marrow Transplantation
George W Pratt, Andy Fan, Bissrat Melakeberhan, Catherine M Klapperich
Proper management of an HIV infection requires that a patient be at least 80-95% adherent to a prescribed drug regimen to avoid poor health outcomes and the development of drug-resistant HIV strains. Clinicians generally monitor adherence habits indirectly through patient self-reporting, pill counting, and electronic drug monitoring. While direct measurement of patient samples like urine for monitoring drug levels is possible, it requires specialized equipment and training that is not readily available in resource-limited settings where the need is greatest...
August 9, 2018: Analytica Chimica Acta
Loraine Van Slyke, Mia Scott
HIV pre-exposure prophylaxis (PrEP) with emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF) fixed-dose combination (FTC/TDF) is undergoing rapid scale-up in the United States. While FTC/TDF is typically well tolerated, to our knowledge, cranial nerve pathology associated with FTC/TDF has not been previously described. We report the case of a 35-year-old patient who began FTC/TDF PrEP and developed acute trigeminal neuralgia. The neurologic symptoms resolved after treatment discontinuation and recurred upon rechallenge, resulting in permanent discontinuation of PrEP treatment...
January 2018: Journal of the International Association of Providers of AIDS Care
Dimitrios Pilalas, Lemonia Skoura, Apostolia Margariti, Fani Chatzopoulou, Dimitrios Chatzidimitriou, Olga Tsachouridou, Pantelis Zebekakis, Simeon Metallidis, Maria Papaioannou
OBJECTIVES: Despite successful virological suppression, HIV transcription frequently persists intracellularly. In this study, we hypothesize that HIV persistent transcription(HIVpt) may affect to a different extent patients on stable efavirenz(EFV) versus atazanavir(ATV)-based regimens. The role of the expression of drug efflux transporters in HIVpt was also investigated. METHODS: We prospectively enrolled 51 virologically suppressed patients on first-line treatment for one year with EFV or ATV combined with emtricitabine and tenofovir and followed them up for one year...
2018: PloS One
Theodoros Kelesidis, Carlee B Moser, Elizabeth Johnston, James H Stein, Michael P Dube, Otto O Yang, Grace A McComsey, Judith S Currier, Todd T Brown
BACKGROUND: The contributions of the Receptor activator of nuclear factor kappa-B ligand (RANKL)/osteoprotegerin (OPG) axis to cardiovascular and bone disease in treated HIV-1 infection is not well-defined. SETTING: Prospective, observational, longitudinal study. METHODS: In a subset analysis of a prospective randomized clinical trial, 234 HIV-1-infected antiretroviral therapy (ART)-naïve participants received tenofovir-emtricitabine plus either atazanavir/ritonavir, darunavir/ritonavir, or raltegravir and achieved plasma HIV-1 RNA <50 copies/ml by week 24 and thereafter...
March 12, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Cynthuja Thilakanathan, Gabrielle Wark, Michael Maley, Scott Davison, Joseph Lawler, Aimei Lee, Nicholas Shackel, Vi Nguyen, Kathy Jackson, Anne Glass, Stephen A Locarnini, Miriam T Levy
BACKGROUND/AIMS: Anti-partum antiviral therapy in the setting of high viral load is recommended to prevent mother-to-child transmission of hepatitis B although recommended viral load cut-offs vary. Quantitative HBsAg has been proposed as an alternative screening strategy to identify high viral load in this setting. Guidelines suggest testing all infants for vaccine response and infection. We set out to re-examine viral load cut-offs; the predictive value of quantitative HBsAg and the need for follow-up infant testing in our cohort...
March 12, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Monica Gandhi, Rajesh T Gandhi, Andrei Stefanescu, Ronald J Bosch, Joshua C Cyktor, Howard Horng, Alexander Louie, Nhi Phung, Joseph J Eron, Evelyn Hogg, Bernard J C Macatangay, Christopher Hensel, Courtney V Fletcher, John W Mellors, Deborah K McMahon
Data on the relationship of antiretroviral exposure to measures of human immunodeficiency virus (HIV) persistence are limited. To address this gap, multiple viral, immunologic, and pharmacologic measures were analyzed from individuals with sustained virologic suppression on therapy (median 7 years) in the AIDS Clinical Trials Group A5321 cohort. Among 110 participants on tenofovir-(TFV)-disoproxil-fumarate (TDF)/emtricitabine (FTC)-containing regimens, we found no significant correlation between hair concentrations of individual antiretrovirals (ARVs) in the regimen and measures of HIV persistence (plasma HIV-1 RNA by single copy assay, cell-associated-DNA, cell-associated RNA) or soluble markers of inflammation...
February 26, 2018: Journal of Infectious Diseases
Muge Cevik, Chloe Orkin
PURPOSE OF REVIEW: In an era when virological efficacy approaches 100%, novel antiretroviral (ARV) therapies must deliver better tolerability, safety, and convenient coformulated regimens. We review the phase II and III clinical data on the fixed dose combination (FDC) darunavir (DRV) 800mg / cobicistat (COBI/C) 150 mg / emtricitabine (F/FTC) 200 mg / tenofovir alafenamide fumarate (TAF) 10mg (D/C/F/TAF) for the treatment of HIV-1 infection. RECENT FINDINGS: In an exploratory phase II study, D/C/F/TAF FDC demonstrated similar virological efficacy to darunavir/cobicistat FDC + F /tenofovir disoproxil fumarate (TDF) FDC in treatment-naive HIV-1-infected individuals with favorable bone and renal outcomes...
March 9, 2018: Current Opinion in HIV and AIDS
Erik Mogalian, Luisa M Stamm, Anu Osinusi, Diana M Brainard, Gong Shen, Kah Hiing John Ling, Anita Mathias
Background: Combining antiviral regimens in the HCV/HIV coinfected population can be complex as they share overlapping mechanisms for elimination that may result in potential drug interactions. The pharmacokinetics, safety, and tolerability of concomitantly administered sofosbuvir/velpatasvir (SOF/VEL) with multiple commonly prescribed antiretroviral (ARV) regimens were evaluated. Methods: Healthy volunteers were enrolled into two phase 1, open-label, randomized, multiple-dose, cross-over studies...
March 7, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Mara Farcasanu, Douglas S Kwon
PURPOSE OF REVIEW: Young women in sub-Saharan Africa bear a disproportionate burden of the global HIV epidemic. In this review, we examine how cervicovaginal microbiota modulate structural and immune defenses in the female genital tract and influence HIV susceptibility. RECENT FINDINGS: Highly diverse, anaerobic cervicovaginal microbiota prevalent in sub-Saharan African women increase HIV acquisition risk by over fourfold. These bacteria weaken the barrier properties of the vaginal mucosa and increase local inflammation and HIV target cell recruitment, creating an environment permissive to HIV...
March 8, 2018: Current HIV/AIDS Reports
Ming-Te Kuo, Po-Lin Tseng, Yeh-Pin Chou, Kuo-Chin Chang, Ming-Chao Tsai, Yuan-Hung Kuo, Tsung-Hui Hu, Chao-Hung Hung, Jing-Houng Wang, Sheng-Nan Lu, Chien-Hung Chen
BACKGROUND AND AIM: This study investigated whether hepatitis B surface antigen (HBsAg) could predict HBV relapse after cessation of entecavir or tenofovir disoproxil fumarate (TDF) prophylaxis for chronic hepatitis B (CHB) cancer patients who are undergoing chemotherapy. METHODS: The study enrolled 122 hepatitis B e antigen (HBeAg)-negative cancer patients who underwent chemotherapy with entecavir or TDF for anti-viral prophylaxis and post-treatment follow-up for at least 6 months...
March 7, 2018: Journal of Gastroenterology and Hepatology
Gonzague Jourdain, Nicole Ngo-Giang-Huong, Linda Harrison, Luc Decker, Woottichai Khamduang, Camlin Tierney, Nicolas Salvadori, Tim R Cressey, Wasna Sirirungsi, Jullapong Achalapong, Prapap Yuthavisuthi, Prateep Kanjanavikai, Orada P Na Ayudhaya, Thitiporn Siriwachirachai, Sinart Prommas, Prapan Sabsanong, Aram Limtrakul, Supang Varadisai, Chaiwat Putiyanun, Pornnapa Suriyachai, Prateung Liampongsabuddhi, Suraphan Sangsawang, Wanmanee Matanasarawut, Sudanee Buranabanjasatean, Pichit Puernngooluerm, Chureeratana Bowonwatanuwong, Thanyawee Puthanakit, Virat Klinbuayaem, Satawat Thongsawat, Sombat Thanprasertsuk, George K Siberry, Diane H Watts, Nahida Chakhtoura, Trudy V Murphy, Noele P Nelson, Raymond T Chung, Stanislas Pol, Nantasak Chotivanich
BACKGROUND: Pregnant women with an elevated viral load of hepatitis B virus (HBV) have a risk of transmitting infection to their infants, despite the infants' receiving hepatitis B immune globulin. METHODS: In this multicenter, double-blind clinical trial performed in Thailand, we randomly assigned hepatitis B e antigen (HBeAg)-positive pregnant women with an alanine aminotransferase level of 60 IU or less per liter to receive tenofovir disoproxil fumarate (TDF) or placebo from 28 weeks of gestation to 2 months post partum...
March 8, 2018: New England Journal of Medicine
Faith Jelagat Lelei-Mailu, Charles Muriuki Mariara
This case report is of a 32-year-old woman of African descent on follow-up for pregnancy in the background of portal hypertension due to liver cirrhosis. She had initially been treated for chronic hepatitis B infection with lamivudine and tenofovir, complicated by portal hypertension and variceal bleeding that thrice required banding. Her pregnancy was uneventful until 31 weeks gestation when she presented with dyspnoea. On examination and investigation, she had oedema, bilateral pleural effusions and ascites...
March 5, 2018: BMJ Case Reports
Zobair M Younossi, Maria Stepanova, Harry L A Janssen, Kosh Agarwal, Mindie H Nguyen, Ed Gane, Naoky Tsai, Issah Younossi, Andrei Racila
BACKGROUND AND AIM: Chronic infection with hepatitis B virus (HBV) causes liver disease and cirrhosis. It is not clear how treatment of chronic HBV infection affects patient-reported outcomes (PROs). We aimed to assess changes in PROs in patients treated for chronic HBV infection. METHODS: We collected and analyzed PRO data from 242 patients with chronic HBV infection (without advanced fibrosis or cirrhosis) enrolled in 2 international phase 2 blinded controlled clinical trials from 2015 through 2017...
March 2, 2018: Clinical Gastroenterology and Hepatology
Joseph Rwagitinywa, Maryse Lapeyre-Mestre, Robert Bourrel, Jean-Louis Montastruc, Agnès Sommet
Adherence to antiretroviral (ARV) is crucial to achieve viral load suppression in HIV-infected patients. This study aimed to compare adherence to generic multi-tablet regimens (MTR) ver-sus brand MTR likely to incorporate ARV drugs without breaking fixed-dose combinations (FDC) and brand single-tablet regimens (STR) likely to incorporate generics by breaking the FDC. Patients aged of 18 years or over, exposed to one of the generic or the brand of lamivu-dine (3TC), zidovudine/lamivudine (AZT/TC), nevirapine (NVP), or efavirenz (EFV), or the brand STR of efavirenz/emtricitabine/tenofovir (EFV/FTC/TDF)...
March 5, 2018: Fundamental & Clinical Pharmacology
William Brown, Rebecca Giguere, Alan Sheinfil, Mobolaji Ibitoye, Ivan Balan, Titcha Ho, Benjamin Brown, Luis Quispe, Wichuda Sukwicha, Javier R Lama, Alex Carballo-Diéguez, Ross D Cranston
BACKGROUND: We implemented a text message-based Short Message Service computer-assisted self-interviewing (SMS-CASI) system to aid adherence and monitor behavior in MTN-017, a phase 2 safety and acceptability study of rectally-applied reduced-glycerin 1% tenofovir gel compared to oral emtricitabine/tenofovir disoproxil fumarate tablets. We sought to implement SMS-based daily reminders and product use reporting, in four countries and five languages, and centralize data management/automated-backup...
February 28, 2018: Journal of Biomedical Informatics
Christopher Loens, Sabine Amet, Corinne Isnard-Bagnis, Gilbert Deray, Jérôme Tourret
The remarkable improvement of the outcome of HIV infection came with the price of substantial toxicity of some antiretrovirals. The first molecules used to treat HIV included an important nephrotoxicity. Zalcitabine, stavudine and didanosine can induce severe lactic acidosis. Lactate production is enhanced and the renal capacity to regulate pH is overwhelmed. However, this side effect is not due to a direct dysfunction of the kidneys. Zalcitabine was withdrawn from the market because of this risk. Indinavir, a protease inhibitor, is soluble only in very acidic solutions...
February 27, 2018: Néphrologie & Thérapeutique
L Ryom, C Boesecke, M Bracchi, J Ambrosioni, A Pozniak, J Arribas, G Behrens, Pgm Mallon, M Puoti, A Rauch, J M Miro, O Kirk, C Marzolini, J D Lundgren, M Battegay
BACKGROUND: The European AIDS Clinical Society (EACS) Guidelines have since 2005 provided multidisciplinary recommendations for the care of HIV-positive persons in geographically diverse areas. GUIDELINE HIGHLIGHTS: Major revisions have been made in all sections of the 2017 Guidelines: antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Newly added are also a summary of the main changes made, and direct video links to the EACS online course on HIV Management...
March 1, 2018: HIV Medicine
Joanne LaFleur, Adam P Bress, Joel Myers, Lisa Rosenblatt, Jacob Crook, Kristin Knippenberg, Roger Bedimo, Pablo Tebas, Heather Nyman, Stephen Esker
INTRODUCTION: Tenofovir disoproxil fumarate (TDF) has been associated with greater incidences of bone complications, which might be modified by some concomitantly administered antiretrovirals, possibly by their effect on tenofovir concentrations. We compared bone adverse outcomes among treatment-naïve HIV-infected US veterans initiating efavirenz (EFV)-containing TDF/emtricitabine (FTC) regimens versus those initiating non-EFV-containing TDF/FTC regimens. METHODS: Using national Veterans Health Administration clinical and administrative data sets, we identified a cohort of treatment-naïve HIV-infected veterans without bone disease who initiated therapy with TDF/FTC plus EFV, rilpivirine, elvitegravir/cobicistat, or ritonavir-boosted protease inhibitors in 2003-2015...
February 28, 2018: Infectious Diseases and Therapy
Guan-Huei Lee, Masafumi Inoue, Roxanne Hui-Heng Chong, Jimmy Toh, Sue Yuen Wee, Kah-Sin Loh, Seng-Gee Lim
Hepatitis B (HBV) drug resistance assay is important for guiding therapy after the development of virologic breakthrough for patients receiving nucleoside/-tide analog therapy. However, the existing genotyping tools are either costly or lack sensitivity to detect mixed genotypes, and an improved method of resistant mutation detection is needed. An assay protocol for clinical application using pyrosequencing method was developed, capable of detecting all known validated HBV polymerase gene mutations that impart resistance to lamivudine, adefovir, tenofovir, and entecavir...
February 28, 2018: Journal of Medical Virology
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